Individual provider Active NPI

Rubi Jimenez

  • Pharmacist
  • Waterbury, CT
National Provider Identifier
1407442155
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0015305 Issued in CT
Practice address
240 Chase Ave
Waterbury, CT 06704-2237
Phone
(203) 916-2888
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
Yes

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0015305CTMDPharmacist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0015305 CT Primary

Addresses

NPPES NPI Registry

Primary practice location

240 Chase Ave
Waterbury, CT 06704-2237

Mailing address

2778 E Main St
Waterbury, CT 06705-2839
Phone (203) 916-2888

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 11, 2026.

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1407442155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2778 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067052839",
            "telephone_number": "203-916-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CHASE AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067042237",
            "telephone_number": "203-916-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "RUBI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2026-05-11",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "0015305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.