Kimberly Mix

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

10151 Deerwood Park Blvd Ste 250
Jacksonville, FL 32256-0566

Phone

(904) 533-4783

NPI assigned

Mar 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Prestige Senior Care

  • Clinical Child & Adolescent Psychologist
  • Jacksonville, FL
  • NPI 1275113565
  NPD Authorized official
• Golden Heart Companion Care

  • Home Health Agency
  • Washington, DC
  • NPI 1659222784

  Home Health Aide

  NPD Authorized official
• Innovative Home Health Agency

  • Home Health Registered Nurse
  • Charlotte, NC
  • NPI 1356114870
  NPD

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1154907897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 GATE PKWY W UNIT 1330",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161072",
            "telephone_number": "904-533-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD STE 250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560566",
            "telephone_number": "904-533-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIX",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joslyn Amelia Mitchem, LPTA
• Ghada Mitri, MD
• Ghaith Mitri, M.D.
• Brittany Nicole Mitrick
• Milan Mitrovic, LMFT
• Derek Kenneth Mixon, DPT
• Detrese Denese Mixon, CNA,CMA
• Tiffany Mixon
• Akili Mixson
• Justice Mixson

• Home Health Aide in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Home Health Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.