Individual provider Active NPI

Christopher Robert Jimenez, FNP

  • Family Nurse Practitioner
  • Bayamon, PR
National Provider Identifier
1851164552
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11029362 Issued in FL
Practice address
Ext. Villa Rica
Calle Rita Aa30
Bayamon, PR 00959-0095
Phone
(787) 325-3630
NPI assigned
Nov 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11029362 FL Primary

Addresses

Primary practice location

Ext. Villa Rica
Calle Rita Aa30
Bayamon, PR 00959-0095

Mailing address

Ext. Villa Rica
Calle Rita Aa30
Bayamon, PR 00959
Phone (787) 325-3630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20241112004435 PR Practitioner - Nurse Practitioner 6406380526 Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11029362FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1851164552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EXT. VILLA RICA",
            "address_2": "CALLE RITA AA30",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-325-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EXT. VILLA RICA",
            "address_2": "CALLE RITA AA30",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009590095",
            "telephone_number": "787-325-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERT JIMENEZ",
        "first_name": "CHRISTOPHER",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11029362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.