Shane Jaimez, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10975826-4405 Issued in UT

Practice address

5097 S 900 E Ste 100
Salt Lake Cty, UT 84117-5725

Phone

(801) 851-5554

NPI assigned

Dec 17, 2018

Sex

Male

Sole proprietor

No

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

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kindly MD, Inc.Group PAC ID 8921471897, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21160/brand/1/csg/1/fhir/r4

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.

• Kindly MD, Inc.

  • General Practice Physician
  • Millcreek, UT
  • NPI 1225647480
  Medicare reassignment Care Compare group NPD
• Hope Family Medical Center LLC

  • Family Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1134570328
  Medicare reassignment NPD
• Kindly LLC

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1487446324
  Medicare reassignment NPD
• Anywhere Care

  • Family Nurse Practitioner
  • Sandy, UT
  • NPI 1841803137
  NPD Authorized official
• Elevate Surgical PC

  • Orthopaedic Surgery Physician
  • Ogden, UT
  • NPI 1952064198
  NPD

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1780156661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5097 S 900 E STE 100",
            "city": "SALT LAKE CTY",
            "state": "UT",
            "postal_code": "841175725",
            "telephone_number": "801-851-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5097 S 900 E STE 100",
            "city": "SALT LAKE CTY",
            "state": "UT",
            "postal_code": "841175725",
            "telephone_number": "801-851-5554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 E 5900 S Ste B109",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841077293",
            "country_code": "US",
            "telephone_number": "385-275-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIMEZ",
        "first_name": "SHANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-17",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10975826-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Deforest Futrell, DC
• Javier Gamarra, CSW
• Paige Huff, LCSW
• Franklin Huggins, PHARMD
• Majd Ibrahim, M.D.
• Rachel Ellen Jones, LCSW
• Amley Elizabeth Kerr
• Shami Niccole King
• Timothy Pickett, P.A.
• Carilyn Pointer

• Family Nurse Practitioner in Salt Lake Cty, UT
• Providers in Salt Lake Cty, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.