Individual provider Active NPI

Deborah Lee Mininger, NP

  • Nurse Practitioner
  • Merced, CA
National Provider Identifier
1467558791
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP11825 Issued in CA
Practice address
3349 G St Ste F
Merced, CA 95340
Phone
(209) 349-8459
Fax
(209) 349-8650
NPI assigned
Sep 15, 2006
Last updated
Jul 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP11825 CA Primary
Family Nurse Practitioner 363LF0000X 11825 CA

Addresses

Primary practice location

3349 G St Ste F
Merced, CA 95340

Mailing address

PO Box 3768
Merced, CA 95344-3768
Phone (209) 667-0702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP11825CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1467558791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3768",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953443768",
            "telephone_number": "209-667-0702",
            "fax_number": "209-667-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 G ST STE F",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95340",
            "telephone_number": "209-349-8459",
            "fax_number": "209-349-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MININGER",
        "first_name": "DEBORAH",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP11825",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "11825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.