Individual provider Active NPI

Jamiela Anne Dimora, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1194128405
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
267496-1 Issued in NY
Practice address
59 Long Wood Dr
Rochester, NY 14612-2711
Phone
(585) 734-9452
NPI assigned
Sep 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 267496-1 NY Primary

Addresses

Primary practice location

59 Long Wood Dr
Rochester, NY 14612-2711

Mailing address

59 Long Wood Dr
Rochester, NY 14612-2711
Phone (585) 734-9452

Other names 1

  • Jamiela Anne Bach Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
267496-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1194128405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 LONG WOOD DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146122711",
            "telephone_number": "585-734-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 LONG WOOD DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146122711",
            "telephone_number": "585-734-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMORA",
        "first_name": "JAMIELA",
        "middle_name": "ANNE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "267496-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIELA",
            "last_name": "BACH",
            "middle_name": "ANNE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.