Individual provider Active NPI

Trevor Thomas Nimmons, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Melbourne, FL
National Provider Identifier
1427189448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
OS 8272 Issued in FL
Practice address
1751 Sarno Rd
Ste 3
Melbourne, FL 32935-4909
Phone
(321) 795-2273
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X OS 8272 FL Primary

Addresses

Primary practice location

1751 Sarno Rd
Ste 3
Melbourne, FL 32935-4909

Mailing address

210 Michigan Ave
Indialantic, FL 32903-3118
Phone (321) 795-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000624 FL Practitioner - Osteopathic Manipulative Medicine 0749207041 Practice locations: Indialantic, FL; Melbourne, FL

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 Michigan Ave
Indialantic, FL 32903-3118
Phone (321) 795-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS 8272FLMDNeuromusculoskeletal Medicine & OMM Physician

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427189448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MICHIGAN AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033118",
            "telephone_number": "321-795-2273",
            "fax_number": "321-253-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 SARNO RD",
            "address_2": "STE 3",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354909",
            "telephone_number": "321-795-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMMONS",
        "first_name": "TREVOR",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS 8272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.