Jimmy L Mathis

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

License

00093077 Issued in NV

Practice address

2123 Civic Center Dr
N Las Vegas, NV 89030-6327

Phone

(702) 772-8063

NPI assigned

Sep 12, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• JLM Imaging LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • N Las Vegas, NV
  • NPI 1326751512
  NPD Authorized official
• JLM Imaging LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • North Las Vegas, NV
  • NPI 1851001291
  NPD Authorized official

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1720709397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 CIVIC CENTER DR",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890306327",
            "telephone_number": "702-772-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 CIVIC CENTER DR",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890306327",
            "telephone_number": "702-772-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "JIMMY",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NV",
            "license": "00093077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Ultrasound Physician in N Las Vegas, NV
• Providers in N Las Vegas, NV by specialty
• Diagnostic Ultrasound Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.