Kelley Marie Jimenez

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202010841 Issued in VA

Practice address

11 Dairy LN
Fredericksburg, VA 22405-2663

Phone

(540) 371-9414

NPI assigned

Nov 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Temple Foundation Inc

  • Physical Therapy Clinic/Center
  • Fairfax, VA
  • NPI 1336366079

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1710439989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DAIRY LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 DAIRY LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052663",
            "telephone_number": "540-371-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "KELLEY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Jergenson, PT, DPT
• Elisabeth Margaret Jerome, PHD
• Ann Michelle Jespersen, SLP
• Emily Zuczka Jett, BCBA
• Susanna Tingle Jett
• Maria Alice A Jimenez, LPC
• Amy Kristen Jindra, LPC
• Jonathan Jo
• Joanne Cozzati LCSW PLLC
• Deborah Ann Jockin, L.C.S.W.

• Speech-Language Pathologist in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.