Individual provider Active NPI

Sayomi Mishima, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Joppa, MD
National Provider Identifier
1083592539
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R223938 Issued in MD
Practice address
630 Towne Center Dr
Joppa, MD 21085-4440
Phone
(410) 510-7099
Fax
(410) 510-7955
NPI assigned
Aug 23, 2025
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R223938 MD Primary

Addresses

Primary practice location

630 Towne Center Dr
Joppa, MD 21085-4440

Mailing address

630 Towne Center Dr
Joppa, MD 21085-4440
Phone (410) 510-7099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251117000266 MD Order and Referring Only - Nurse Practitioner 8729576863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R223938MDMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1755907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1083592539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 TOWNE CENTER DR",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210854440",
            "telephone_number": "410-510-7099",
            "fax_number": "410-510-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 TOWNE CENTER DR",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210854440",
            "telephone_number": "410-510-7099",
            "fax_number": "410-510-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHIMA",
        "first_name": "SAYOMI",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-23",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R223938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joppa, MD

Sources for this page

Verify at the official NPI Registry.