Active NPI
Nicole Mims, PT
- Physical Therapist
- Austin, TX
National Provider Identifier
1306338405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1308509
- Practice address
- 1033 La Posada Dr Ste 230
Austin, TX 78752-3842 - Phone
- (512) 284-7192
- NPI assigned
- Jun 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1308509 | TX | Primary |
Addresses
Primary practice location
1033 La Posada Dr Ste 230
Austin, TX 78752-3842
Mailing address
1033 La Posada Dr Ste 230
Austin, TX 78752-3842
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21470457 | Other | TX | DRIVER LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Austin | Direct |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mondo Sports Therapy, LLC | Single Specialty | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588032000000",
"number": "1306338405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1033 LA POSADA DR STE 230",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787523842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 LA POSADA DR STE 230",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787523842",
"telephone_number": "512-284-7192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIMS",
"first_name": "NICOLE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-04",
"last_updated": "2020-04-28",
"certification_date": "2020-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "TX",
"license": "1308509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE",
"identifier": "21470457",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Austin",
"affiliation": "N",
"endpointDescription": "Austin",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1033 La Posada Dr Ste 230",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "787523842",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.