Active NPI
Derrika Nimmers
- Occupational Therapist
- Carson, CA
National Provider Identifier
1922497171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11996
- Practice address
- 21901 Moneta Ave Unit 43
Carson, CA 90745-2858 - Phone
- (310) 946-1563
- NPI assigned
- Jan 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11996 | CA | Primary |
Addresses
Primary practice location
21901 Moneta Ave Unit 43
Carson, CA 90745-2858
Mailing address
21901 Moneta Ave Unit 43
Carson, CA 90745-2858
Phone (310) 946-1563
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11996 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421020800000",
"number": "1922497171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21901 MONETA AVE UNIT 43",
"city": "CARSON",
"state": "CA",
"postal_code": "907452858",
"telephone_number": "310-946-1563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21901 MONETA AVE UNIT 43",
"city": "CARSON",
"state": "CA",
"postal_code": "907452858",
"telephone_number": "310-946-1563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIMMERS",
"first_name": "DERRIKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-12",
"last_updated": "2015-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "11996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.