Mia Robernette Tait, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

864476 Issued in MS

Practice address

1 CVS Dr
Woonsocket, RI 02895-6195

Phone

(401) 581-6303

NPI assigned

Sep 14, 2019

Last updated

Jan 22, 2025By the provider in NPPES

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

• Mia Robernette James Former name

Medicare fee-for-service enrollment

Enrolled in MS, LA2 enrollments

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 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MDB Behavioral Health Services LLC

  dba Complete Care Rural Health Clinic

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Medicare reassignment NPD
• Minuteclinic Diagnostic of Louisiana, LLC

  • Family Nurse Practitioner
  • New Orleans, LA
  • NPI 1285975482
  Medicare reassignment NPD

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

{
    "created_epoch": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1376193094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 CONSTITUTION RD",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395626375",
            "telephone_number": "228-712-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956195",
            "telephone_number": "401-581-6303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14601 Constitution Rd",
            "address_purpose": "LOCATION",
            "city": "Moss Point",
            "state": "MS",
            "postal_code": "395626375",
            "country_code": "US",
            "telephone_number": "251-776-2015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAIT",
        "first_name": "MIA",
        "middle_name": "ROBERNETTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-14",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "864476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "JAMES",
            "middle_name": "ROBERNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan D Morin (Morin Therapy)
• Allison Sutherland
• Elaine A Sylvester
• Tamara H Sylvestre, MSPT
• Katherine Szurley
• Olawale E Taiwo
• Vida Tajiknia, MD
• Taranpreet Takhar
• Varsha Raveesh Talanki
• David Russell Talbert, PHARM.D.

• Family Nurse Practitioner in Woonsocket, RI
• Providers in Woonsocket, RI by specialty
• Family Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.