Active NPI
Olga Lidia Jimenez, SLP
- Speech-Language Pathologist
- Fairfax, VA
National Provider Identifier
1528080611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202003713
- Practice address
- 3750 Old Lee Hwy
Fairfax, VA 22030-1806 - Phone
- (703) 246-5314
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202003713 | VA | Primary |
Addresses
Primary practice location
3750 Old Lee Hwy
Fairfax, VA 22030-1806
Mailing address
3002 White Birch CT
Fairfax, VA 22031-1122
Phone (703) 246-9489
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2202003713 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528080611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3002 WHITE BIRCH CT",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220311122",
"telephone_number": "703-246-9489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 OLD LEE HWY",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220301806",
"telephone_number": "703-246-5314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "OLGA",
"middle_name": "LIDIA",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202003713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.