Individual provider Active NPI

Jennifer Stephanie Jimenez, DPM

  • Podiatrist
  • Annandale, VA
National Provider Identifier
1467011288
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103301345 Issued in VA
Practice address
3301 Woodburn Rd Ste 208
Annandale, VA 22003-1200
Phone
(703) 942-9845
Fax
(703) 560-1329
NPI assigned
Jun 6, 2019
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103301345 VA Primary

Addresses

Primary practice location

3301 Woodburn Rd Ste 208
Annandale, VA 22003-1200

Mailing address

Geisinger Medical Center 100 North Academy Avenue
Danville, PA 17822-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250310000954 DC Practitioner - Podiatry 7416490339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3301 Woodburn Rd
Suite 208
Annandale, VA 22003-1200
Phone (703) 942-9845

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue19
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1467011288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178220001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN RD STE 208",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031200",
            "telephone_number": "703-942-9845",
            "fax_number": "703-560-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JENNIFER",
        "middle_name": "STEPHANIE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.