Active NPI
Teresa Mims
- Occupational Therapy Assistant
- Manning, SC
National Provider Identifier
1154442804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 886
- Practice address
- 1026 Radius St
Manning, SC 29102-7836 - Phone
- (843) 598-9306
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 886 | SC | Primary |
| Occupational Therapist | 225X00000X | 4582 | SC |
Addresses
Primary practice location
1026 Radius St
Manning, SC 29102-7836
Mailing address
1026 Radius St
Manning, SC 29102-7836
Phone (843) 598-9306
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4582 | SC | MD | General Practice Dentistry |
| 886 | SC | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faith Therapeutic Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Manning, SC
- NPI 1598006942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441843200000",
"number": "1154442804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1026 RADIUS ST",
"city": "MANNING",
"state": "SC",
"postal_code": "291027836",
"telephone_number": "843-598-9306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1026 RADIUS ST",
"city": "MANNING",
"state": "SC",
"postal_code": "291027836",
"telephone_number": "843-598-9306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIMS",
"first_name": "TERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2015-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "SC",
"license": "886",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "4582",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manning, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.