Juan Miguel Jimenez

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

713 NW 139TH St
Edmond, OK 73013-1912

Phone

(702) 249-1309

NPI assigned

Sep 22, 2020

Last updated

Sep 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1295341337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 NW 139TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131912",
            "telephone_number": "702-249-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 NW 139TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131912",
            "telephone_number": "702-249-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JUAN",
        "middle_name": "MIGUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Jhanda
• Xue Jiao
• Jim R. Keller, PH.D., Specialists in Psychological Counseling & Consul
• Jim Wallace & Associates, Inc (The Jetty Counseling Center)
• Gabrielle Michelle Jimenez, DNP, APRN, FNP-C
• Susana Jimenez, PHYSICIAN ASSISTANT
• Jnkynp, LLC. (visiting NP)
• Joe M. Harris, DDS, PC
• Joel M Davis MD PHD PLLC
• John Atwood Clinical Psychologist Inc

• Peer Specialist in Edmond, OK
• Providers in Edmond, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.