Individual provider Active NPI

Terrill Jimoh

  • Student in an Organized Health Care Education/Training Program
  • Moore, OK
National Provider Identifier
1306383880
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2900 S Service Rd Apt 1515
Moore, OK 73160-5585
Phone
(405) 589-9207
NPI assigned
Jan 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Athletic Trainer 2255A2300X

Addresses

Primary practice location

2900 S Service Rd Apt 1515
Moore, OK 73160-5585

Mailing address

2900 S Service Rd Apt 1515
Moore, OK 73160-5585
Phone (405) 589-9207

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

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1306383880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S SERVICE RD APT 1515",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605585",
            "telephone_number": "405-589-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S SERVICE RD APT 1515",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605585",
            "telephone_number": "405-589-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMOH",
        "first_name": "TERRILL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.