Individual provider Active NPI

Jeffrey Wayne Dimon, R.PH

  • Pharmacist
  • Des Moines, IA
National Provider Identifier
1780204438
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18354 Issued in IA
Practice address
3330 MLK Jr Pkwy
Des Moines, IA 50310-5672
Phone
(515) 255-6213
Fax
(515) 255-8806
NPI assigned
Apr 23, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18354 IA Primary

Addresses

Primary practice location

3330 MLK Jr Pkwy
Des Moines, IA 50310-5672

Mailing address

Hy-Vee
3330 MLK Parkway
Des Moines, IA 50310
Phone (515) 255-6213

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
18354IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1780204438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HY-VEE",
            "address_2": "3330 MLK PARKWAY",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50310",
            "telephone_number": "515-255-6213",
            "fax_number": "515-255-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 MLK JR PKWY",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105672",
            "telephone_number": "515-255-6213",
            "fax_number": "515-255-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMON",
        "first_name": "JEFFREY",
        "middle_name": "WAYNE",
        "credential": "R.PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "18354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.