Mikkelsen, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MIKKELSEN, LLC

Practice address

4200 South Fwy
Suite 615
Fort Worth, TX 76115-1400

Phone

(817) 210-4778

NPI assigned

Oct 28, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Lincoln Mikkelsen

Title

Manager

Phone

(616) 723-5020

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1124328877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY",
            "address_2": "SUITE 615",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151400",
            "telephone_number": "817-210-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY",
            "address_2": "SUITE 615",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151400",
            "telephone_number": "817-210-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKKELSEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "MIKKELSEN",
        "authorized_official_first_name": "LINCOLN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "616-723-5020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos J Mijares, MD
• Lisa Diane Mijares, AGNP
• Adriana Mikals
• Jack L Mikeworth, D.C.
• David Mikitka, D.D.S.
• Mikulencak Orthodontics
• David Matthew Mikulencak, DDS, MS
• Mila Family Health
• Lisa Marie Miladinovich, PTA
• Mary Milam, MD

• In Home Supportive Care Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.