Kristine Nichole Mims, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403546 Issued in NY

Practice address

6129 Cordero Dr
Cicero, NY 13039-7813

Phone

(315) 276-9936

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristine Nichole Laflair Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

I -View Psychiatric NP Behavioral Therapy PCGroup PAC ID 2264715630, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• I - View Psychiatric NP Behavioral Therapy PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Syracuse, NY
  • NPI 1720535099
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1164092532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6129 CORDERO DR",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130397813",
            "telephone_number": "315-276-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6129 CORDERO DR",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130397813",
            "telephone_number": "315-276-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "KRISTINE",
        "middle_name": "NICHOLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "LAFLAIR",
            "middle_name": "NICHOLE",
            "credential": "PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Noah B Meldrum, LMSW
• William Melfi
• Melissa Cohen DPM PLLC
• Sara Jane Micale, PHARM.D.
• Margaret Janet Miller, FNP
• Puanani Eve Miner, LPN
• Mini Milestones Physical Therapy, PC
• Misty Lea Mitchell, LPN
• Nicole Marie Montanaro, PHARMD
• Courtney Janne Mooney, RPH

• Psychiatric/Mental Health Nurse Practitioner in Cicero, NY
• Providers in Cicero, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.