MEDICARE: JULIE JIMERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	119742	MO
2	2251X0800X	Orthopedic Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	119742	OTHER	MO	LICENSE #

General Provider Information

NPI Number	:	1295844488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE JIMERSON

Provider Business Mailing Address
First Line	:	3016 SW SADDLEWOOD PL
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64081-3826
Country	:	US
Telephone Number	:	816-304-7442
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 S STATE ROUTE 291
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-1201
Country	:	US
Telephone Number	:	816-373-9328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	02/12/2026

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Directions to “ JULIE JIMERSON ” Practice Location

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