Individual provider Active NPI

Ricardo Rafael Jimenez, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Atlanta, GA
National Provider Identifier
1184709180
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
2026039595 Issued in MO
Practice address
1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Phone
(404) 785-2285
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 054901 GA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 2026039595 MO Primary

Addresses

Primary practice location

1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605

Mailing address

1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Phone (404) 785-2285

Other practice location 1

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131223000878 TN Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6800023706 Reassigns benefits to 1 organization
I20190905000709 GA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6800023706 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
054901GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Jul 1, 2019 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC CurrentSince Nov 15, 2013 Accepting new patients
Gwinnett Emergency Specialists, LLC CurrentSince Jul 23, 2023 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

910 Blackford St
Chattanooga, TN 37403
Phone (423) 778-4044

Interoperability endpoints

  • Direct secure messaging: rjimenez66299@choa.gadirect.net

Organizations & group practices 3

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1184709180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "404-785-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "404-785-2285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-617-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "RICARDO",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "054901",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "2026039595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.