Active NPI
Jennifer Nim, O.D.
- Optometrist
- Mt Pleasant, UT
National Provider Identifier
1336302876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV007287
- Practice address
- 1125 S Blackhawk Blvd
Mount Pleasant, UT 84647 - Phone
- (435) 287-0563
- NPI assigned
- Jul 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV007287 | NY | Primary |
Addresses
Primary practice location
1125 S Blackhawk Blvd
Mount Pleasant, UT 84647
Mailing address
62 W Center St # 280
Fairview, UT 84629-9997
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 85.95 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 53.16
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV007287 | NY | MD | Optometrist |
| 007287 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirk Eye LLC | Current | Accepting new patients | |
| Visionworks, Inc | Current | Accepting new patients | |
| Visionworks, Inc. | Optometrist | Current | Accepting new patients |
| Tuttle Dermatology PC | Past | Accepting new patients |
Locations
1125 Blackhawk Blvd
Mt Pleasant, UT 84647
Phone (435) 986-7156
10317 S State St
Sandy, UT 84070
Phone (801) 572-4810
Networks
- UT PPO
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.
-
dba Dermatology Clinic of Southern Utah
- Dermatology Physician
- St George, UT
- NPI 1598261869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1336302876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 W CENTER ST # 280",
"city": "FAIRVIEW",
"state": "UT",
"postal_code": "846299997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 S BLACKHAWK BLVD",
"city": "MOUNT PLEASANT",
"state": "UT",
"postal_code": "84647",
"telephone_number": "435-287-0563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIM",
"first_name": "JENNIFER",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-03",
"last_updated": "2022-08-23",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV007287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.