Anthony K. Mikasobe, BSMT, AMT, ASCP

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

22459 Issued in TN

Practice address

9409 Whittingham Dr
Brentwood, TN 37027-8460

Phone

(615) 472-8312

Fax

(615) 472-8312

NPI assigned

Feb 20, 2009

Sex

Male

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": "1235088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235088000000",
    "number": "1609016336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22043",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372022043",
            "telephone_number": "615-472-8312",
            "fax_number": "615-472-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 WHITTINGHAM DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278460",
            "telephone_number": "615-472-8312",
            "fax_number": "615-472-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKASOBE",
        "first_name": "ANTHONY",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "BSMT, AMT, ASCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "22459",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "3653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Michelle Middleton, AUD
• Midsouth First Assist, LLC
• Judy Mier-Chairez, PHD
• Sara S Miers, AUD
• Dennis James Mihalek Jr.
• Carolynn Jeanne Mikulka, LPC-MHSP
• Sara Thane Milam, LCSW
• Sarah Beacham Milam, LMFT
• Petra Milde, M.D.
• Laurie Ann Miles

• Clinical Medical Laboratory in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Clinical Medical Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.