Kimberly Ibarra

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

3610 Williams Dr
Georgetown, TX 78628-2420

Phone

(512) 256-7627

NPI assigned

Aug 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• All Care Therapies of Georgetown, PLLC

  • Occupational Therapist
  • Georgetown, TX
  • NPI 1033538921
  Medicare reassignment
• Allied Therapies of Texas, PLLC

  • Multi-Specialty Clinic/Center
  • Copperas Cove, TX
  • NPI 1164009254
  NPD (past)

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1962130146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 TANGLEWOOD LN",
            "city": "HUTTO",
            "state": "TX",
            "postal_code": "786345151",
            "telephone_number": "512-966-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282420",
            "telephone_number": "512-256-7627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Tanglewood Ln",
            "address_purpose": "LOCATION",
            "city": "Hutto",
            "state": "TX",
            "postal_code": "786345151",
            "country_code": "US",
            "telephone_number": "512-966-9304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBARRA",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Megan N Ibanez, M.A., LMFT
• Joseph C Ikekwere, M.D, MPH
• Imedtx LLC
• Impact Counseling Services, Inc.
• Impact Health Labs LLC
• Elias Victor I Impens, MD

• Speech-Language Pathologist in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.