Individual provider Active NPI

Minx Damron Fite, FNP-C

  • Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1366059057
Registry record updated Sep 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN261614 Issued in GA
Practice address
701 S Cloudas Ave
Sioux Falls, SD 57103-2421
Phone
(478) 972-6680
NPI assigned
Sep 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN261614 GA Primary

Addresses

Primary practice location

701 S Cloudas Ave
Sioux Falls, SD 57103-2421

Mailing address

701 S Cloudas Ave
Sioux Falls, SD 57103-2421
Phone (478) 972-6680

Other practice location 1

325 Heritage Dr
Macon, GA 31210-5288
Phone (478) 972-6680

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

State licenses

LicenseStateTypeSpecialty
RN261614GAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1601078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601078400000",
    "number": "1366059057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S CLOUDAS AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571032421",
            "telephone_number": "478-972-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S CLOUDAS AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571032421",
            "telephone_number": "478-972-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Heritage Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312105288",
            "country_code": "US",
            "telephone_number": "478-972-6680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITE",
        "first_name": "MINX",
        "middle_name": "DAMRON",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-26",
        "last_updated": "2020-09-26",
        "certification_date": "2020-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN261614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

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

Verify at the official NPI Registry.