Active NPI
Melisa Tanisha Mims
- Personal Care Attendant
- Arlington, VA
National Provider Identifier
1174136444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 2611 South Clark Street
Suite 700
Arlington, VA 22201 - Phone
- (844) 381-4432
- Fax
- (877) 763-2165
- NPI assigned
- Aug 26, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 0 | DC | Primary |
Addresses
Primary practice location
2611 South Clark Street
Suite 700
Arlington, VA 22201
Mailing address
1070 Mount Olivet Rd NE Apt C42
Washington, DC 20002-2233
Phone (202) 421-4553
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1174136444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 MOUNT OLIVET RD NE APT C42",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200022233",
"telephone_number": "202-421-4553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2611 SOUTH CLARK STREET",
"address_2": "SUITE 700",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "22201",
"telephone_number": "844-381-4432",
"fax_number": "877-763-2165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIMS",
"first_name": "MELISA",
"middle_name": "TANISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-26",
"last_updated": "2020-08-26",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "DC",
"license": "0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.