Active NPI
Richard Jimines X, DC
- Chiropractor
- Warren, MI
National Provider Identifier
1598749830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301400093
- Practice address
- 15111 E 13 Mile Rd
Warren, MI 48088-3396 - Phone
- (586) 415-8068
- Fax
- (586) 415-8145
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301400093 | MI | Primary |
Addresses
Primary practice location
15111 E 13 Mile Rd
Warren, MI 48088-3396
Mailing address
15111 E 13 Mile Rd
Warren, MI 48088-3396
Phone (586) 415-8068
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 950E051410 | Other | MI | BLUECROSS BLUESHIELD OF M |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598749830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15111 E 13 MILE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480883396",
"telephone_number": "586-415-8068",
"fax_number": "586-415-8145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15111 E 13 MILE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480883396",
"telephone_number": "586-415-8068",
"fax_number": "586-415-8145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMINES",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"name_suffix": "X",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301400093",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD OF M",
"identifier": "950E051410",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.