JOHANA BEATRIZ GIMENEZ (NPI# 1417478629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417478629 |
| Entity Type | Individual |
| Full Name | JOHANA BEATRIZ GIMENEZ |
| Other Name | JOHANA BEATRIZ GIMENEZ RODRIGUEZ |
| Credential | MD |
| Practice Address |
15 Founders Ln Ste 100 Jacksonville IL 62650-3924 |
| Mailing Address |
Po Box 3428 Springfield IL 62708-3428 |
| Practice Telephone | 2172430300 |
| Practice Fax Number | 2172456775 |
| Mailing Telephone | 2175882624 |
| Mailing Fax Number | 2177572021 |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2020-05-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 036.152253 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MD LICENSE | 036.152253 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4500 Parsons Blvd, Flushing, NY 113552205 | 7186705535 |
| Street Address |
15 FOUNDERS LN STE 100 |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-3924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396369187 | Im Sulzbacher Center for The Homeless, Inc | Pediatrics | 5455 Springfield Blvd, Jacksonville, FL 32208-5166 | 2020-06-08 |
| 1609334515 | Jeremy N Harris, M.d., P.a. | Pediatrics | 3636 University Blvd S Ste B3, Jacksonville, FL 32216-4223 | 2019-03-10 |
| 1851856975 | Aksharbrahma Pa | Pediatrics | 6100 Greenland Rd Ste 301, Jacksonville, FL 32258-2626 | 2019-02-02 |
| 1184116972 | North Florida Pediatrics, Pa | Pediatrics | 9770 Old Bay Meadows Road, Suite 101, Jacksonville, FL 32256-7986 | 2018-06-06 |
| 1235654781 | Gabriella Assi, Md, LLC | Pediatrics | 5851 Saint Augustine Rd, Jacksonville, FL 32207-8015 | 2017-08-06 |
| 1386185932 | Myrna B Ginter | Pediatrics | 3805 Ortega Blvd, Jacksonville, FL 32210-4415 | 2017-03-15 |
| 1831639400 | Children's Health Associates | Pediatrics | 3710 Grandy Ave, Jacksonville, FL 32207-6112 | 2017-03-02 |
| 1770039687 | Hampton Pediatrics Pa | Pediatrics | 11512 Lake Mead Ave Unit 201, Jacksonville, FL 32256-9688 | 2016-08-30 |
| 1447508478 | Starfish Pediatrics Pa | Pediatrics | 4500 Hodges Blvd, Suite 1, Jacksonville, FL 32224-2207 | 2012-08-23 |
| 1336495662 | Tariq Gulzar | Pediatrics | 6353 Argyle Forest Blvd Ste 4, Jacksonville, FL 32244-6602 | 2012-07-24 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.