Individual provider Active NPI

Jaime Pimental, FNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1790142735
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5008315 Issued in NC
Practice address
7903 Providence Rd
Suite 100
Charlotte, NC 28277-9720
Phone
(704) 316-4460
NPI assigned
Jan 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5008315 NC
Nurse Practitioner 363L00000X 5008315 NC Primary

Addresses

Primary practice location

7903 Providence Rd
Suite 100
Charlotte, NC 28277-9720

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-4460

Other identifiers 1

IdentifierTypeStateIssuer
1790142735MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpimental41312@direct.novanthealth.org

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160503001532 NC Practitioner - Nurse Practitioner 6709185374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

332 N Trade St
Suite 2000a
Matthews, NC 28105-1728
Phone (704) 302-8860

4525 Cameron Valley Pkwy
Suite 4100D
Charlotte, NC 28211-4369
Phone (980) 402-1800

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5008315NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 4, 2021 Accepting new patients
Atrium Health North Market Network LLC CurrentSince Jul 1, 2022 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 4, 2021 Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

7903 Providence Rd
Ste 100
Charlotte, NC 28277
Phone (704) 316-4460

16645 Birkdale Commons Pkwy
Ste 100
Huntersville, NC 28078
Phone (704) 801-7390

332 N Trade St
Ste 2000A
Matthews, NC 28105
Phone (704) 302-8860

Interoperability endpoints

  • Direct secure messaging: jpimental41312@direct.novanthealth.org
  • Direct secure messaging: jpimental528444@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1790142735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-4460",
            "fax_number": "704-316-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7903 PROVIDENCE RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282779720",
            "telephone_number": "704-316-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMENTAL",
        "first_name": "JAIME",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008315",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790142735",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpimental41312@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "7903 Providence Rd",
            "address_2": "Suite 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282779720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.