Active NPI
Jared Christian Nimtz, MD
- Plastic Surgery Physician
- Lexington, KY
National Provider Identifier
1114180221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 46515
- Practice address
- 715 Shaker Dr
Suite 100
Lexington, KY 40504-3662 - Phone
- (859) 277-9435
- Fax
- (859) 277-8852
- NPI assigned
- Jul 8, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 46515 | KY | Primary |
Addresses
Primary practice location
715 Shaker Dr
Suite 100
Lexington, KY 40504-3662
Mailing address
715 Shaker Dr
Suite 100
Lexington, KY 40504-3662
Phone (859) 277-9435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539734400000",
"number": "1114180221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 SHAKER DR",
"address_2": "SUITE 100",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405043662",
"telephone_number": "859-277-9435",
"fax_number": "859-277-8852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 SHAKER DR",
"address_2": "SUITE 100",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405043662",
"telephone_number": "859-277-9435",
"fax_number": "859-277-8852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIMTZ",
"first_name": "JARED",
"middle_name": "CHRISTIAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-08",
"last_updated": "2018-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "KY",
"license": "46515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.