Individual provider Active NPI

Mimose Joseph, CNA

  • Home Health Aide
  • Homestead, FL
National Provider Identifier
1083335871
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
CNA40738 Issued in FL
Practice address
13270 SW 256TH St
Homestead, FL 33032-6821
Phone
(786) 348-8491
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X CNA40738 FL Primary

Addresses

Primary practice location

13270 SW 256TH St
Homestead, FL 33032-6821

Mailing address

13270 SW 256TH St
Homestead, FL 33032-6821
Phone (786) 348-8491

Other identifiers 1

IdentifierTypeStateIssuer
CNA40738OtherFLNURSING ASSISTANT CERTIFICATION

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
CNA40738FLMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1083335871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13270 SW 256TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330326821",
            "telephone_number": "786-348-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13270 SW 256TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330326821",
            "telephone_number": "786-348-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "MIMOSE",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": "CNA40738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING ASSISTANT CERTIFICATION",
            "identifier": "CNA40738",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.