Individual provider Active NPI

Daniel E Jimenez, MD

  • Emergency Medicine Physician
  • Fort Belvoir, VA
National Provider Identifier
1699756569
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101028078 Issued in VA
Practice address
9501 Farrell Rd
Fort Belvoir, VA 22060-5901
Phone
(703) 805-0414
NPI assigned
Nov 8, 2005
Last updated
Jan 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101028078 VA Primary

Addresses

Primary practice location

9501 Farrell Rd
Fort Belvoir, VA 22060-5901

Mailing address

9501 Farrell Rd
Fort Belvoir, VA 22060-5901
Phone (703) 805-0414

Other identifiers 2

IdentifierTypeStateIssuer
P00189309OtherRAILROAD MCR
10116112MedicaidVA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101028078VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johnston Memorial Hospital, Inc Past Accepting new patients
Hospital Physician Services, LLLP Past Accepting new patients
Sterling Emergency Services of Virginia Inc Emergency Medicine Past Accepting new patients
Ecs of Virginia, Inc. Emergency Medicine Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200441600000",
    "number": "1699756569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 FARRELL RD",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605901",
            "telephone_number": "703-805-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 FARRELL RD",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605901",
            "telephone_number": "703-805-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "DANIEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2008-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101028078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P00189309",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10116112",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.