Active NPI
Kimberly Medina, MA, MS, ED.S
- School Psychologist
- Rockville, MD
National Provider Identifier
1659265783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 1001704131
- Practice address
- 850 Hungerford Dr
Rockville, MD 20850-1718 - Phone
- (240) 740-5640
- NPI assigned
- Jun 4, 2025
- Last updated
- Jun 24, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1001704131 | MD | Primary |
Addresses
Primary practice location
850 Hungerford Dr
Rockville, MD 20850-1718
Mailing address
850 Hungerford Dr
Rockville, MD 20850-1718
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
- Credentials
- Master of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001704131 | MD | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1659265783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 HUNGERFORD DR",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 HUNGERFORD DR",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501718",
"telephone_number": "240-740-5640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "MA, MS, ED.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-04",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MD",
"license": "1001704131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.