Victor M Jimenez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301086868 Issued in MI

Practice address

2442 Black Horse Dr NE
Grand Rapids, MI 49505-3968

Phone

(616) 957-9261

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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.

• Central Michigan Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Big Rapids, MI
  • NPI 1598856734
  NPD (past)
• West Michigan Rehab PLLC

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
  • NPI 1851588859
  NPD (past)
• Serv Emerg del Noroeste

  • Multi-Specialty Clinic/Center
  • Aguada, PR
  • NPI 1558468876
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1528045333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 BLACK HORSE DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053968",
            "telephone_number": "616-957-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 BLACK HORSE DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053968",
            "telephone_number": "616-957-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "VICTOR",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2021-01-12",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301086868",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301086868",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301086868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lissette Jimenez, MD
• Maria Elena Jimenez
• Priscilla Jimenez, PMHNP-BC
• Raelynn Jimenez
• Reyna Doris Mae Jimenez
• Latroya Erica Jinwright
• Grace Makenna Jipping, PHARMD
• JKG Counseling & Recovery LLC
• JLS Counseling & Mentoring LLC
• Jo Kelly Counseling Services LLC

• Family Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.