Individual provider Active NPI

Teresa Nimmo, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Little Rock, AR
National Provider Identifier
1225253248
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
E-5408 Issued in AR
Practice address
1 Saint Vincent Cir Ste 410
Little Rock, AR 72205-5409
Phone
(501) 762-8056
Fax
(501) 781-2490
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X E-5408 AR Primary

Addresses

Primary practice location

1 Saint Vincent Cir Ste 410
Little Rock, AR 72205-5409

Mailing address

1 Saint Vincent Cir Ste 410
Little Rock, AR 72205-5409
Phone (501) 762-8056

Other identifiers 3

IdentifierTypeStateIssuer
5H251OtherARBLUE CROSS BLUE SHIELD
08080015600OtherQUAL CHOICE
P00630198OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 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
I20080902000298 AR Practitioner - EndocrinologyPractitioner - Internal Medicine 7416023213 Reassigns benefits to 1 organization
I20241224000175 MO Practitioner - Internal Medicine 7416023213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Tennessee, HSC, College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1 Saint Vincent Cir
Suite 410
Little Rock, AR 72205-5409
Phone (501) 762-8056

1 St Vincent Circle
Suite 410
Little Rock, AZ 72205-5405

1965 S Fremont Ave
220 SPRG Ped Endocrin Diabetes Fremont
Springfield, MO 65804-2283
Phone (417) 820-0280

Hospital & facility affiliations

  • CHI-St Vincent Infirmary Hospital, Little Rock, AR, CCN 040007
  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-5408ARMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Dec 16, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Dec 16, 2024 Accepting new patients
Little Rock Endocrinology Services Endocrinology, Diabetes & Metabolism CurrentSince Dec 1, 2011 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Dec 16, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1 Saint Vincent Cir
Ste 410
Little Rock, AR 72205
Phone (501) 663-9000

11400 Huron Ln
Little Rock, AR 72211
Phone (501) 224-0794

500 S University Ave
Ste 615
Little Rock, AR 72205
Phone (501) 666-3666

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1965 S Fremont Ave
Ste 220
Springfield, MO 65804
Phone (417) 820-0280

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: nimmo.teresa.002.0040009@jthmd.meditab.direct-ci.com
  • Direct secure messaging: nimmo.teresa.020.0040009@jthmd.meditab.direct-ci.com

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1225253248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT VINCENT CIR STE 410",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055409",
            "telephone_number": "501-762-8056",
            "fax_number": "501-781-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT VINCENT CIR STE 410",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055409",
            "telephone_number": "501-762-8056",
            "fax_number": "501-781-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMMO",
        "first_name": "TERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AR",
            "license": "E-5408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5H251",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "08080015600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00630198",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.