Hernan John Jimenez-Medina, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2007-00878 Issued in ND

Practice address

568 Ruin Creek Rd
Suite 128
Henderson, NC 27536-2880

Phone

(252) 436-1380

Fax

(252) 436-1581

NPI assigned

Jun 23, 2005

Last updated

Jul 23, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DLP Maria Parham Physician Practices, LLC

  dba Maria Parham Primary Care

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1215273628
  Medicare reassignment NPD
• DLP Maria Parham Physician Practices LLC

  • Rural Health Clinic/Center
  • Henderson, NC
  • NPI 1578256749
  NPD
• DLP Maria Parham Physician Practices, LLC

  dba Maria Parham Orthopaedics

  • Orthopaedic Surgery Physician
  • Henderson, NC
  • NPI 1558750893
  NPD
• Ankle and Foot Surgical and Podiatry Clinic PA

  • Foot & Ankle Surgery Podiatrist
  • West End, NC
  • NPI 1063648533
  NPD (past)
• Coastal Rehabilitation Associates

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wilmington, NC
  • NPI 1851348981
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1285630301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD",
            "address_2": "SUITE 128",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362880",
            "telephone_number": "252-436-1380",
            "fax_number": "252-436-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD",
            "address_2": "SUITE 128",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362880",
            "telephone_number": "252-436-1380",
            "fax_number": "252-436-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ-MEDINA",
        "first_name": "HERNAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ND",
            "license": "2007-00878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0184009",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1417179730",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Interventional Pain Center, PLLC
• John Christopher Jaeger, O.D.
• Kristen Shernell Jefferson
• Clifton Keith Jeffries IV, MSW LCSW-A
• Brittini Lynn Jennings, LCASA
• Alyssa Michelle Johnson
• Janet Johnson, LCAS-A
• Melissa Johnson
• Nia Rikhel Johnson, MD
• Khadene Asha-Marie Jones-Barnett, FNP

• Physical Medicine & Rehabilitation Physician in Henderson, NC
• Providers in Henderson, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.