Provider Demographics
NPI:1447270160
Name:JONES, KIMBERLY D (AUD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:JONES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:D
Other - Last Name:SWISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5135
Mailing Address - Fax:740-446-5958
Practice Address - Street 1:100 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:740-446-5135
Practice Address - Fax:740-446-5958
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01357231H00000X
OH01357231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0098579Medicaid
OH310917085193OtherOH MEDICAID CARESOURCE
WV3405006000Medicaid
WV3405006000Medicaid
OHJE4233241Medicare PIN