Individual provider Active NPI

Kimberly S. Joiner, AU.D.

  • Audiologist
  • Brunswick, GA
National Provider Identifier
1578796744
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD001149 Issued in GA
Practice address
3025 Shrine Rd Ste 490
Brunswick, GA 31520-4784
Phone
(912) 267-1569
Fax
(912) 261-8285
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD001149 GA Primary

Addresses

Primary practice location

3025 Shrine Rd Ste 490
Brunswick, GA 31520-4784

Mailing address

3025 Shrine Rd Ste 490
Brunswick, GA 31520-4784
Phone (912) 267-1569

Other identifiers 2

IdentifierTypeStateIssuer
000896288BMedicaidGA
000896288FMedicaidGA

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
1149GAMDAnatomic Pathology Physician
AUD001149GAMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1578796744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 SHRINE RD STE 490",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204784",
            "telephone_number": "912-267-1569",
            "fax_number": "912-261-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 SHRINE RD STE 490",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204784",
            "telephone_number": "912-267-1569",
            "fax_number": "912-261-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOINER",
        "first_name": "KIMBERLY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD001149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000896288B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000896288F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.