Jimmy Diaz, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

26097 Issued in GA

Practice address

214 Professional Cir Ste a
Saint Marys, GA 31558-3783

Phone

(912) 729-6606

Fax

(912) 729-4307

NPI assigned

Aug 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• McKinney Community Health Ctr, Inc

  • Federally Qualified Health Center (FQHC)
  • Blackshear, GA
  • NPI 1568623346
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1396853891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 QUARTERMAN ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013547",
            "telephone_number": "912-729-6606",
            "fax_number": "912-729-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 PROFESSIONAL CIR STE A",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583783",
            "telephone_number": "912-729-6606",
            "fax_number": "912-729-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JIMMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "26097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000320581E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anushka Adil Desai
• Judy Ann Deshea, OTR/L
• Mary Lou Devaul - Eshleman, D.O.
• Madison Raine Dewar
• Dezz, Inc
• Winston E Dill, JDPHDPSYDDNP
• Donald Scott Dills, LDO
• Daniel A. Dino, M.D.
• Dr. Victoria Warner-White
• Neil Edwin Duchac II, PH.D.

• All providers in Saint Marys, GA
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.