Individual provider Active NPI

Randi Marie Jimenez, D.C.

  • Chiropractor
  • Fairfield, CT
National Provider Identifier
1396979365
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001742 Issued in CT
Practice address
2452 Black Rock Tpke Ste 9
Fairfield, CT 06825-2407
Phone
(203) 583-6894
Fax
(203) 372-1348
NPI assigned
May 6, 2009
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001742 CT Primary

Addresses

Primary practice location

2452 Black Rock Tpke Ste 9
Fairfield, CT 06825-2407

Mailing address

2452 Black Rock Tpke Ste 9
Fairfield, CT 06825-2407
Phone (203) 583-6894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001742CTMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lilian Youssef-Awad Sole Proprietor Chiropractor PastSince May 11, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1396979365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2452 BLACK ROCK TPKE STE 9",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068252407",
            "telephone_number": "203-583-6894",
            "fax_number": "203-372-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 BLACK ROCK TPKE STE 9",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068252407",
            "telephone_number": "203-583-6894",
            "fax_number": "203-372-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "RANDI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.