Individual provider Active NPI

Julie Cimino, PNP

  • Pediatric Nurse Practitioner
  • Marion, OH
National Provider Identifier
1053691568
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
COA.12598-NP Issued in OH
Practice address
1040 Delaware Ave
Marion, OH 43302-6416
Phone
(740) 383-8090
Fax
(740) 375-6481
NPI assigned
Aug 29, 2011
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NP12598 OH
Pediatric Nurse Practitioner 363LP0200X COA.12598-NP OH Primary

Addresses

Primary practice location

1040 Delaware Ave
Marion, OH 43302-6416

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other identifiers 2

IdentifierTypeStateIssuer
NP12598OtherOHOHIO STATE LICENSE
0052852MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.12598-NPOHMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1053691568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 DELAWARE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026416",
            "telephone_number": "740-383-8090",
            "fax_number": "740-375-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMINO",
        "first_name": "JULIE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "NP12598",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "COA.12598-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE LICENSE",
            "identifier": "NP12598",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052852",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.