KELLEY MARIE JIMENEZ
NPI 1710439989
Speech-Language Pathologist in Fredericksburg, VA
About Kelley Marie Jimenez NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLEY MARIE JIMENEZ (NPI 1710439989) is an individual speech-language pathologist provider in Fredericksburg, Virginia, licensed in Virginia (2202010841) and active in the NPI registry since November 2016.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelley Marie Jimenez is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelley Jimenez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fairfax, VA 22031
- Reassigned Medicare billing, District of Columbia enrollment
- 25 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FREDERICKSBURG, VA 22405
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelley Jimenez's NPI number?
The NPI number for Kelley Jimenez is 1710439989. It was assigned to this individual provider in the NPPES registry on November 3, 2016.
Where is Kelley Jimenez located?
Kelley Jimenez practices at 11 Dairy Ln, Fredericksburg, VA 22405. The listed phone number is (540) 371-9414.
What is Kelley Jimenez's specialty?
The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.
Is Kelley Jimenez enrolled in Medicare?
Yes. Kelley Jimenez is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelley Jimenez's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Jimenez reassigns Medicare benefits to The Temple Foundation Inc (Fairfax, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelley Jimenez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelley Jimenez was last updated on February 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelley Marie Jimenez · NPI 1710439989
Speech-Language Pathologist provider in Fredericksburg, Virginia. Individual provider, active in the CMS NPPES registry since November 3, 2016.
## Identity
- **NPI:** 1710439989 (Entity type: Individual)
- **Enumerated:** November 3, 2016
- **Primary specialty:** Speech-Language Pathologist · taxonomy 235Z00000X
- **State license:** 2202010841 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 11 DAIRY LN, Fredericksburg, VA 22405-2663
- **Phone:** (540) 371-9414
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** The Temple Foundation Inc (NPI 1336366079, Fairfax, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 27, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1710439989) · Data from the CMS NPPES public registry.