Individual provider Active NPI

Daniel Roy Mims, RPH

  • Pharmacist
  • Montgomery, AL
National Provider Identifier
1346319043
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13854 Issued in AL
Practice address
400 Interstate Park Dr
Suite 422
Montgomery, AL 36109-5428
Phone
(334) 356-7627
Fax
(334) 356-7647
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13854 AL Primary

Addresses

Primary practice location

400 Interstate Park Dr
Suite 422
Montgomery, AL 36109-5428

Mailing address

400 Interstate Park Dr
Suite 422
Montgomery, AL 36109-5428
Phone (334) 356-7627

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13854ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346319043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE PARK DR",
            "address_2": "SUITE 422",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361095428",
            "telephone_number": "334-356-7627",
            "fax_number": "334-356-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE PARK DR",
            "address_2": "SUITE 422",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361095428",
            "telephone_number": "334-356-7627",
            "fax_number": "334-356-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "DANIEL",
        "middle_name": "ROY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "13854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.