Kelley B Jimison, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

140352 Issued in GA

Practice address

30 Jesse Hill Jr Drive
Atlanta, GA 30303

Phone

(404) 616-5650

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

Yes

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1891715074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 BISHOP CREEK DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 JESSE HILL JR DRIVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30303",
            "telephone_number": "404-616-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMISON",
        "first_name": "KELLEY",
        "middle_name": "B",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "140352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruben Erick Jimenez
• Stephany Jimenez
• Tia Jimenez
• Bridgette Jimerson
• Christine Carol Jiminez, PA
• Jimmie E. Williams, M.D., P.C.
• Jimmy'S Magnolia Tree Inc
• Jindal Psychiatry, L.L.C.
• Gaurav Jindal, MD
• Hyder Jinnah, MD PHD

• Pediatric Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.