Katina Mintz

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

G122094 Issued in SC

Practice address

1314 Chandler Cir
Florence, SC 29505-6464

Phone

(843) 319-3708

NPI assigned

Sep 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1497305841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 CHANDLER CIR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056464",
            "telephone_number": "843-319-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 CHANDLER CIR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056464",
            "telephone_number": "843-319-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "KATINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "SC",
            "license": "G122094",
            "primary": false
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Contractor, Home Modifications",
            "state": "SC",
            "license": "G122094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Modifications Contractor in Florence, SC
• Providers in Florence, SC by specialty
• Home Modifications Contractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.