Mycheal L Mimes

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1500 N Market St Unit C
Shreveport, LA 71107

Phone

(318) 626-5597

NPI assigned

May 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1417485012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N MARKET ST UNIT C",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N MARKET ST UNIT C",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71107",
            "telephone_number": "318-626-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMES",
        "first_name": "MYCHEAL",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851741722",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milton Slocum MD Apmc
• Caleb Johan Milton, RBT
• Quanerick Milton
• Victor Milus
• Wenona Milus, M.ED, RSW
• Theresa Lafaye Mims-Bell
• La'Keachie Mims
• Miesha A Mims, NP
• George Samir Nemr Mina, MD
• Alireza Minagar, M.D.

• Case Manager/Care Coordinator in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.