Active NPI
Jacob Powell Nimmo, AU.D.
- Audiologist
- Mather, CA
National Provider Identifier
1700687449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU3999
- Practice address
- 10535 Hospital Way
Mather, CA 95655-4200 - Phone
- (916) 257-3997
- NPI assigned
- Mar 20, 2025
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU3999 | CA | Primary |
Addresses
Primary practice location
10535 Hospital Way
Mather, CA 95655-4200
Mailing address
10535 Hospital Way
Mather, CA 95655-4200
Phone (916) 257-3997
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AU3999 | CA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742428800000",
"number": "1700687449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10535 HOSPITAL WAY",
"city": "MATHER",
"state": "CA",
"postal_code": "956554200",
"telephone_number": "916-257-3997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10535 HOSPITAL WAY",
"city": "MATHER",
"state": "CA",
"postal_code": "956554200",
"telephone_number": "916-257-3997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIMMO",
"first_name": "JACOB",
"middle_name": "POWELL",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-20",
"last_updated": "2025-03-20",
"certification_date": "2025-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU3999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mather, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.