Individual provider Active NPI

Jennifer Kimsey

  • Phlebotomy Technician
  • Martin, TN
National Provider Identifier
1407685910
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
11600-PT Issued in TN
Practice address
521 Weakley Rd
Martin, TN 38237-8110
Phone
(731) 318-6186
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246RP1900X 11600-PT TN Primary

Addresses

Primary practice location

521 Weakley Rd
Martin, TN 38237-8110

Mailing address

521 Weakley Rd
Martin, TN 38237-8110
Phone (731) 318-6186

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
11600-PTTNMDPhlebotomy Technician

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1407685910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 WEAKLEY RD",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382378110",
            "telephone_number": "731-318-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 WEAKLEY RD",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382378110",
            "telephone_number": "731-318-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMSEY",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "TN",
            "license": "11600-PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.