Individual provider Active NPI

Nico Jimmerson

  • Physical Therapist
  • Rockville, MD
National Provider Identifier
1144877861
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212701 Issued in VA
Practice address
2401 Research Blvd
Rockville, MD 20850-3215
Phone
(301) 337-6921
NPI assigned
Aug 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305212701 VA Primary

Addresses

Primary practice location

2401 Research Blvd
Rockville, MD 20850-3215

Mailing address

2401 Research Blvd
Rockville, MD 20850-3215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191031000584 VA Practitioner - Physical Therapist in Private Practice 9931431129 Reassigns benefits to 1 organization
I20240913001330 NC Practitioner - Physical Therapist in Private Practice 9931431129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.57 of 100Reported as group
Quality
98.54
Improvement activities
40
Cost
74.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
Breakthrough Physical Therapy Inc Physical Therapist CurrentSince Jun 17, 2024 Accepting new patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
The Jackson Clinics LLC Physical Therapist PastSince Sep 9, 2019 Accepting new patients
Breakthrough Physical Therapy Physical Therapist Past Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

303 N 35th St
Morehead City, NC 28557
Phone (252) 247-2738

110 Main St
Oxford, NC 27565
Phone (919) 603-5400

1111 Corporate Park Dr
Ste B
Forest, VA 24551
Phone (434) 525-4851

44 Clifton St
Lynchburg, VA 24501
Phone (434) 528-1848

20347 Timberlake Rd
Ste B
Lynchburg, VA 24502
Phone (434) 237-6812

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1144877861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 RESEARCH BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RESEARCH BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503215",
            "telephone_number": "301-337-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMMERSON",
        "first_name": "NICO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.