Individual provider Active NPI

Jimboy Conserman

  • Registered Nurse
  • Glendale, CA
National Provider Identifier
1922976489
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95270659 Issued in CA
Practice address
1717 E Chevy Chase Dr
Glendale, CA 91206-2891
Phone
(929) 386-3437
NPI assigned
Oct 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95270659 CA Primary

Addresses

Primary practice location

1717 E Chevy Chase Dr
Glendale, CA 91206-2891

Mailing address

1717 E Chevy Chase Dr Apt B
Glendale, CA 91206-2891

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

LicenseStateTypeSpecialty
95270659CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1922976489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 E CHEVY CHASE DR APT B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E CHEVY CHASE DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062891",
            "telephone_number": "929-386-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSERMAN",
        "first_name": "JIMBOY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95270659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.