Active NPI
Jaime Nuguid Salomon Jr., MD
- Internal Medicine Physician
- Indianapolis, IN
National Provider Identifier
1174615157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01028799
- Practice address
- 11020 E 10TH St Unit B
Indianapolis, IN 46229-3710 - Phone
- (317) 898-5800
- Fax
- (317) 898-5883
- NPI assigned
- Sep 28, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01028799 | IN | Primary |
| General Practice Physician | 208D00000X | 01028799A | IN |
Addresses
Primary practice location
11020 E 10TH St Unit B
Indianapolis, IN 46229-3710
Mailing address
11020 E 10TH St Unit B
Indianapolis, IN 46229-3710
Phone (317) 898-5800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1028799B | Other | IN | CONTROLLED SUBSTANCEE |
| 01028799A | Other | IN | INDIANA LICENSE |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01028799A | IN | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiro 1St PC of Indiana | Past | Accepting new patients | |
| Chiro 1St PC of Indiana | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Durable Medical Equipment & Medical Supplies
- Indianapolis, IN
- NPI 1710211792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315180800000",
"number": "1174615157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11020 E 10TH ST UNIT B",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462293710",
"telephone_number": "317-898-5800",
"fax_number": "317-898-5883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11020 E 10TH ST UNIT B",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462293710",
"telephone_number": "317-898-5800",
"fax_number": "317-898-5883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALOMON",
"first_name": "JAIME",
"middle_name": "NUGUID",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2011-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01028799",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IN",
"license": "01028799A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONTROLLED SUBSTANCEE",
"identifier": "1028799B",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA LICENSE",
"identifier": "01028799A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.