NPIMap

Organization Active NPI

Mitzi Nikkole

  • Prosthetic/Orthotic Supplier
  • Martin, TN
National Provider Identifier
1134795669
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MITZI NIKKOLE
Practice address
509 Elm St
Martin, TN 38237-3407
Phone
(270) 627-1247
NPI assigned
Jun 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

Name
Mitzi MorrisNPI 1992168363
Title
Owner
Phone
(270) 627-1247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

509 Elm St
Martin, TN 38237-3407

Mailing address

PO Box 13
Hickman, KY 42050-0013
Phone (270) 627-1247

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mitzinikkole@gmail.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Mitzi Nikkole2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1134795669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13",
            "city": "HICKMAN",
            "state": "KY",
            "postal_code": "420500013",
            "telephone_number": "270-627-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 ELM ST",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373407",
            "telephone_number": "270-627-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITZI NIKKOLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "MITZI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-627-1247"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mitzinikkole@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "509 Elm St",
            "city": "Martin",
            "state": "TN",
            "country_code": "US",
            "postal_code": "382373407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Martin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.