Individual provider Active NPI

Marcela Jimenez

  • Registered Nurse
  • Worcester, MA
National Provider Identifier
1386071983
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2280037 Issued in MA
Practice address
548 Park Avenue
Worcester, MA 01603
Phone
(774) 823-1500
NPI assigned
Sep 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2280037 MA Primary

Addresses

Primary practice location

548 Park Avenue
Worcester, MA 01603

Mailing address

548 Park Avenue Suite B
Worcester, MA 01603

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

State licenses

LicenseStateTypeSpecialty
RN2280037MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1386071983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 PARK AVENUE SUITE B",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 PARK AVENUE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01603",
            "telephone_number": "774-823-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "MARCELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2280037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.