Kelsey Renee Jimenez, FNP - BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277003457 Issued in IL

Practice address

1949 S Bridge St
Yorkville, IL 60560-9851

Phone

(630) 999-8665

NPI assigned

May 8, 2018

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

Other names 1

• Kelsey Renee Tassen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1972092716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 BEED AVE",
            "city": "ELBURN",
            "state": "IL",
            "postal_code": "601197826",
            "telephone_number": "248-224-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 S BRIDGE ST",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605609851",
            "telephone_number": "630-999-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "KELSEY",
        "middle_name": "RENEE",
        "credential": "FNP - BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277003457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "TASSEN",
            "middle_name": "RENEE",
            "credential": "FNP - BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tomas A Jakstys, MD
• Jessica Jaquez, P.T.
• Anne Marie Roman Jardeleza, D.D.S.
• Jeff and Kristy Frank 1 Inc
• Rachel Jensen
• Kathryn Mary Johns, LCSW, CADC
• Danielle Johnson
• Debra Annette Johnson, OTR/L
• Desirae Marie Johnson
• Lance Johnson, BCBA

• Family Nurse Practitioner in Yorkville, IL
• Providers in Yorkville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.