MARY REBEKAH JIMENEZ
NPI 1912684028
Nurse Practitioner - Psychiatric/Mental Health in Johnson City, TN

Q: What is Mary Jimenez's NPI number?

The NPI number for Mary Jimenez is 1912684028. It was assigned to this individual provider in the NPPES registry on June 29, 2023.

Q: What is Mary Jimenez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Mary Jimenez was last updated on April 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 29, 2023PECOS EnrolledAccepts Medicare Assignment

403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604(423) 388-9961 Get Directions Write a Review

NPPES record last updated: April 28, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 28, 2026, Aug 7, 2024 (2 updates tracked since 2024).

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About Mary Rebekah Jimenez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY REBEKAH JIMENEZ (NPI 1912684028) is an individual psychiatric/mental health provider in Johnson City, Tennessee, licensed in Tennessee (36821) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, is affiliated with Johnson City Medical Center, and maintains a secondary practice location in Johnson City.

NPPES Registry Identity

NPI1912684028

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMARY REBEKAH JIMENEZ

Location Address403 N STATE OF FRANKLIN RDJohnson City, TN 37604-6034

Mailing AddressPo Box 699Mountain Home, TN 37684-0699

Phone(423) 388-9961

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJune 29, 2023

Last NPPES UpdateApril 28, 20262 updates tracked since enumeration

NPPES CertifiedApril 28, 2026

✔ NPI 1912684028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in TN · 36821

Also ListedRegistered Nurse · Psychiatric/Mental HealthTaxonomy 163WP0808X · License 246367 (TN)

403 N STATE OF FRANKLIN RD, Johnson City, TN 37604

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Secondary Practice Location 1

Location 12 Professional Park Dr Ste 21Johnson City, TN 37604-6584 · Phone (423) 379-8120 · Fax (423) 379-8153

Other Identifiers 2

Medicaid1912684028VA

MedicaidQ098155TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary Rebekah Jimenez is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072040138

PECOS Enrollment IDI20241231002372

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Johnson City Medical Center

Acute Care Hospitals · Johnson City, TN

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440063

Location400 N State Of Franklin RdJohnson City, TN 37604 · Washington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOUNTAIN STATES HEALTH ALLIANCE

Psychiatric Unit