Individual provider Active NPI

Jerry Reimer, M.D.

  • Family Medicine Physician
  • Clovis, CA
National Provider Identifier
1700867678
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G81225 Issued in CA
Practice address
275 W Herndon Ave
Clovis, CA 93612-0204
Phone
(559) 324-6200
Fax
(559) 324-6280
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G81225 CA Primary

Addresses

Primary practice location

275 W Herndon Ave
Clovis, CA 93612-0204

Mailing address

275 W Herndon Ave
Clovis, CA 93612-0204
Phone (559) 324-6200

Other identifiers 3

IdentifierTypeStateIssuer
77040368493612B013OtherCACHAMPUS
00G812250MedicaidCA
00G812250OtherCABLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20080617000742 CA Practitioner - Family Practice 3779654884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Southern California Keck School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2335 E Kashian LN
Fresno, CA 93701-2234

275 W Herndon Ave
Clovis, CA 93612-0204
Phone (559) 324-6200

Hospital & facility affiliations

  • Saint Agnes Home Health and Hospice Home health agency, Fresno, CA, CCN 057135
  • Community Home Care Home health agency, Fresno, CA, CCN 057248
  • Valley Regional Home Health, Inc Home health agency, Fresno, CA, CCN 059575
  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions31
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G81225CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Apr 1, 2014 Accepting new patients
Community Foundation Medical Group Current Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients

Locations

275 W Herndon Ave
Clovis, CA 93612
Phone (559) 321-4255

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

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": "1187740800000",
    "number": "1700867678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120204",
            "telephone_number": "559-324-6200",
            "fax_number": "559-324-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120204",
            "telephone_number": "559-324-6200",
            "fax_number": "559-324-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIMER",
        "first_name": "JERRY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G81225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "77040368493612B013",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G812250",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "00G812250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.