Reginald Bernard Mims Sr.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

105 Oakland Ave
Sanford, FL 32773-6237

Phone

(407) 625-1995

NPI assigned

Jun 3, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 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": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1427672518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 OAKLAND AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327736237",
            "telephone_number": "407-625-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 OAKLAND AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327736237",
            "telephone_number": "407-625-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "REGINALD",
        "middle_name": "BERNARD",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Sanford",
            "affiliation": "N",
            "endpointDescription": "Documents",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Sanford",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Sanford",
            "address_1": "105 Oakland Ave",
            "city": "Sanford",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327736237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in Sanford, FL
• Providers in Sanford, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.