Individual provider Active NPI

Jaime Nuguid Salomon Jr., MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1174615157
Registry record updated Sep 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01028799 Issued in IN
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

Updated by the provider on Sep 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1028799BOtherINCONTROLLED SUBSTANCEE
01028799AOtherININDIANA 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

LicenseStateTypeSpecialty
01028799AINMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro 1St PC of Indiana Past Accepting new patients
Chiro 1St PC of Indiana General Practice PastSince Aug 30, 2018 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.

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.

Verify at the official NPI Registry.