Nathan Jimmerson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 27099 Issued in FL

Practice address

319 W Town PL
World Golf Village, Suite 5
Saint Augustine, FL 32092-3101

Phone

(904) 342-5262

NPI assigned

Jan 16, 2017

Last updated

Jan 16, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1484524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1144766049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 LINWOOD LOOP",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594235",
            "telephone_number": "813-784-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W TOWN PL",
            "address_2": "WORLD GOLF VILLAGE, SUITE 5",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923101",
            "telephone_number": "904-342-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMMERSON",
        "first_name": "NATHAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-16",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 27099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremiah D Gordon, DMD, PA (Gordon Dental Associates)
• Jeremy Caudill DO
• Audrey Lee Jernigan, LMT
• George Alton Jernigan III
• Felicia Ann Jerome, D.O.
• Natasha Jno Baptiste
• Joanne F. Reed, OD, PLLC
• John R Jones Jr LMHC PA
• John S. Koppman MD PL
• Michelle John, RD

• Physical Therapy Assistant in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; 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.