Edgar Jimenez

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

1710058573 Issued in NV

Practice address

2860 E Flamingo Rd Ste K
Las Vegas, NV 89121-5270

Phone

(702) 318-5005

NPI assigned

Jun 22, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1871975219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S JONES BLVD",
            "address_2": "STE E3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 E FLAMINGO RD STE K",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215270",
            "telephone_number": "702-318-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 S Jones Blvd",
            "address_2": "ste E3",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891463182",
            "country_code": "US",
            "telephone_number": "702-425-3377",
            "fax_number": "702-997-7552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "EDGAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NV",
            "license": "1017014744001",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NV",
            "license": "1710058573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE",
            "identifier": "1710058573",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710058573",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catalina Jimenez
• Claudia Jimenez
• Cristain Jimenez
• David Jimenez Jr.
• Diana Jimenez
• Edi Jimenez
• Edith Yael Jimenez, LMSW, CSW-I
• Edward Jimenez
• Elizabeth Jimenez
• Fernando Jimenez

• In Home Supportive Care Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• In Home Supportive Care Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.