Mims Family Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL092045 Issued in NC

Legal business name

MIMS FAMILY CARE HOME

Practice address

6401 Mims Rd
Holly Springs, NC 27540-9561

Phone

(919) 552-6455

Fax

(919) 567-5313

NPI assigned

Jun 20, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Joyce Mims

Title

Adminstrator

Phone

(919) 552-6455

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1396940177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 MIMS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409561",
            "telephone_number": "919-552-6455",
            "fax_number": "919-567-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 MIMS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409561",
            "telephone_number": "919-552-6455",
            "fax_number": "919-567-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIMS FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "919-552-6455",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL092045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801930",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vidushi Mehrotra, D.O.
• Isha Manohar Mehta, M.D.
• Amanda Ward Meisel, CNM
• Kayla Merkel, LCSW
• Robin Elaine Kennel Miller, MS, LAT, ATC, CSCS
• Mims Family Care Home
• Michelle Pamela Mishenko
• MMS Unlimited
• Modern Health Institute PC
• Sweety Mody

• Adult Care Home Facility in Holly Springs, NC
• Providers in Holly Springs, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.