Individual provider Active NPI

Jimmie Rogers Horton Jr., M.D.

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1710114434
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40546 Issued in IA
Practice address
1350 Des Moines St
Suite 110
Des Moines, IA 50309-5507
Phone
(515) 643-0833
Fax
(515) 643-0933
NPI assigned
Jun 20, 2009
Last updated
Feb 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 40546 IA Primary

Addresses

Primary practice location

1350 Des Moines St
Suite 110
Des Moines, IA 50309-5507

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-0833

Other identifiers 1

IdentifierTypeStateIssuer
1710114434MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20121024000750 IA Practitioner - Family Practice 2860642071 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2103 Ingersoll Ave
Suite 2
Des Moines, IA 50312-5227
Phone (515) 323-5680

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40546IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince May 13, 2019 Accepting new patients
Clarinda Regional Health Center Family Medicine CurrentSince Dec 31, 2015 Accepting new patients
Trinity Medical Center Family Medicine Past Accepting new patients
Mercy Clinics Inc Past Accepting new patients

Locations

2720 8th St SW
Ste A2
Altoona, IA 50009
Phone (515) 967-0133

3625 N Ankeny Blvd
Ste E
Ankeny, IA 50023
Phone (515) 965-4664

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

220 Essie Davison Dr
Clarinda, IA 51632
Phone (712) 542-8330

2103 Ingersoll Ave
Ste 2
Des Moines, IA 50312
Phone (515) 323-5680

6520 SE 14th St
Des Moines, IA 50320
Phone (515) 256-4242

1000 W Lincoln Way
Jefferson, IA 50129
Phone (515) 386-2114

610 10th St
Perry, IA 50220
Phone (515) 465-3547

Interoperability endpoints

  • Direct secure messaging: jhorton12661@direct.unitypoint.org

Organizations & group practices 5

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": "1245456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1710114434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-0833",
            "fax_number": "515-643-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 DES MOINES ST",
            "address_2": "SUITE 110",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503095507",
            "telephone_number": "515-643-0833",
            "fax_number": "515-643-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "JIMMIE",
        "middle_name": "ROGERS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-20",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "40546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710114434",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.