Brad Lee Jimmo, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

042-0010388 Issued in VT

Practice address

215 Stratton Rd
Rutland, VT 05701-4621

Phone

(802) 775-7745

Fax

(802) 775-5155

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in VT

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

Specialty

General Surgery

Education

University of Vermont College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rutland Hospital, Inc.Group PAC ID 7214846377, 186 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vna & Hospice of the Southwest Region, Inc. Home health agency, Rutland, VT, CCN 477007
• Rutland Regional Medical Center Hospital, Rutland, VT, CCN 470005

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/6f43d0e7-6ff2-489b-abdc-44e8a5e0ca0a/

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.

• Rutland Hospital, Inc.

  • Specialist
  • Rutland, VT
  • NPI 1083678833
  Medicare reassignment Care Compare group NPD
• Rutland Hospital, Inc

  • Emergency Medicine Physician
  • Rutland, VT
  • NPI 1194789941
  NPD
• Rutland Hospital, Inc.

  • Psychiatric Hospital Unit
  • Rutland, VT
  • NPI 1467416206
  NPD
• Rutland Hospital, Inc.

  • General Acute Care Hospital
  • Rutland, VT
  • NPI 1720042203
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rutland Hospital, Inc.

  • General Acute Care Hospital
  • Rutland, VT
  • NPI 1720042203
  Care Compare affiliation
• Vna & Hospice of the Southwest Region, Inc

  • Home Health Agency
  • Rutland, VT
  • NPI 1407856800
  Care Compare affiliation
• Vna & Hospice of the Southwest Region, Inc.

  • Public Health or Welfare Agency
  • Rutland, VT
  • NPI 1578743621

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1437184637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-775-7745",
            "fax_number": "802-775-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-775-7745",
            "fax_number": "802-775-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMMO",
        "first_name": "BRAD",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VT",
            "license": "042-0010388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008803",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Fauntleroy, M.D., P.C.
• Tina Marie Jensen, PTA
• Zachary Jepson
• John Page Jessup, PSYCHOLOGIST, MA
• Joshua Jewett
• Joanna Gould Counseling
• Alyssa Nicole Johnson, CFY-SLP
• Bonnie L Johnson, NP
• Brodie Anne Johnson
• Catherine Elizabeth Johnson, THERAPIST

• Surgery Physician in Rutland, VT
• Providers in Rutland, VT by specialty
• Surgery Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.

Verify at the official NPI Registry.