Active NPI
Jessica Mimms
- Behavior Analyst
- Deltona, FL
National Provider Identifier
1558922666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-19-36217
- Practice address
- 3263 Sorrel CT
Deltona, FL 32725-3099 - Phone
- (386) 500-6325
- NPI assigned
- Jun 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-19-36217 | Primary |
Addresses
Primary practice location
3263 Sorrel CT
Deltona, FL 32725-3099
Mailing address
3263 Sorrel CT
Deltona, FL 32725-3099
Other practice location 1
12724 Gran Bay Parkway West
Suite 410
Jacksonville, FL 32258-9486
Phone (386) 343-4862
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1558922666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3263 SORREL CT",
"city": "DELTONA",
"state": "FL",
"postal_code": "327253099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3263 SORREL CT",
"city": "DELTONA",
"state": "FL",
"postal_code": "327253099",
"telephone_number": "386-500-6325"
}
],
"practiceLocations": [
{
"address_1": "12724 Gran Bay Parkway West",
"address_2": "Suite 410",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322589486",
"country_code": "US",
"telephone_number": "386-343-4862",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIMMS",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-28",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-19-36217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deltona, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.