Individual provider Active NPI

Estefania Bautista Jimenez

  • Speech-Language Pathologist
  • Gastonia, NC
National Provider Identifier
1659211811
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30004952 Issued in NC
Practice address
1343 E Garrison Blvd
Gastonia, NC 28054-5137
Phone
(704) 785-0560
Fax
(980) 224-8387
NPI assigned
Mar 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30004952 NC Primary

Addresses

Primary practice location

1343 E Garrison Blvd
Gastonia, NC 28054-5137

Mailing address

2010 N Brevard St Apt 514
Charlotte, NC 28206-3940
Phone (707) 932-1872

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
30004952NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Kidz Therapy, LLC Speech-Language Pathologist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1659211811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 N BREVARD ST APT 514",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282063940",
            "telephone_number": "707-932-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1343 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545137",
            "telephone_number": "704-785-0560",
            "fax_number": "980-224-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA JIMENEZ",
        "first_name": "ESTEFANIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30004952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.