Darryl James Mims Jr.

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

941 S McPherson Church Rd
Fayetteville, NC 28303-5369

Phone

(910) 286-4784

NPI assigned

Aug 15, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1003699836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 OLD ENGLISH LN",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283907429",
            "telephone_number": "973-494-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 S MCPHERSON CHURCH RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035369",
            "telephone_number": "910-286-4784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Old English Ln",
            "address_purpose": "LOCATION",
            "city": "Spring Lake",
            "state": "NC",
            "postal_code": "283907429",
            "country_code": "US",
            "telephone_number": "973-494-4906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIMS",
        "first_name": "DARRYL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Behavior Technician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.