Active NPI
Laura Jacimore, PA
- Radiation Oncology Physician
- Rocky Mount, NC
National Provider Identifier
1306020912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- Legal business name
- LAURA JACIMORE, PA
- Practice address
- 2450 Curtis Ellis Dr
Rocky Mount, NC 27804-2237 - Phone
- (252) 443-8947
- Fax
- (252) 451-3090
- NPI assigned
- Dec 19, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Laura Lyn Jacimore, M.D.
- Title
- President
- Phone
- (919) 971-4976
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | Primary |
Addresses
Primary practice location
2450 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Mailing address
105 Monabreeze Way
Garner, NC 27529-4369
Phone (919) 773-3735
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891358H | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
2450 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198022400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629072000000",
"number": "1306020912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 MONABREEZE WAY",
"city": "GARNER",
"state": "NC",
"postal_code": "275294369",
"telephone_number": "919-773-3735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 CURTIS ELLIS DR",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278042237",
"telephone_number": "252-443-8947",
"fax_number": "252-451-3090"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAURA JACIMORE, PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-19",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A",
"authorized_official_last_name": "JACIMORE",
"authorized_official_first_name": "LAURA",
"authorized_official_middle_name": "LYN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "919-971-4976",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Radiation Oncology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891358H",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rocky Mount, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.