Individual provider Active NPI

Joanne Mimm, PT

  • Physical Therapist
  • Rancho Santa Margarita, CA
National Provider Identifier
1407929995
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11613 Issued in CA
Practice address
29803 Santa Margarita Pkwy
Rancho Santa Margarita, CA 92688-3609
Phone
(949) 459-9010
NPI assigned
Nov 15, 2006
Sex
Female
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
Physical Therapist 225100000X PT11613 CA Primary

Addresses

Primary practice location

29803 Santa Margarita Pkwy
Rancho Santa Margarita, CA 92688-3609

Mailing address

29803 Santa Margarita Pkwy
Rancho Santa Margarita, CA 92688-3609
Phone (949) 459-9010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607001468 CA Practitioner - Physical Therapist in Private Practice 5092798587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laguna Beach Rehab IncGroup PAC ID 4688686538, 14 clinicians

Practice addresses (Care Compare)

1441 Avocado Ave
Suite 307
Newport Beach, CA 92660-7704
Phone (949) 640-2121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT11613CAMDPhysical Therapist
11613CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scor Physical Therapy Inc Physical Therapist CurrentSince Aug 1, 2017 Accepting new patients
Victoria Adams PastSince Jan 1, 2016 Accepting new patients
Rancho Santa Margarita Physical Therapy Sports Medicine Inc PastSince Jul 15, 1999 Accepting new patients

Locations

29803 Santa Margarita Pkwy
Rcho Sta Marg, CA 92688
Phone (949) 459-9010

653 Camino de los Mares
Ste 110
San Clemente, CA 92673
Phone (949) 496-0122

Organizations & group practices 4

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407929995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29803 SANTA MARGARITA PKWY",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883609",
            "telephone_number": "949-459-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29803 SANTA MARGARITA PKWY",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883609",
            "telephone_number": "949-459-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMM",
        "first_name": "JOANNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.