Riley Mims

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

PCET003756 Issued in GA

Practice address

618 Bowens Mill Rd SW
Douglas, GA 31533-3926

Phone

(912) 331-0846

Fax

(678) 792-4894

NPI assigned

Jan 2, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Azalea Rehab Services, LLC

  • Speech-Language Pathologist
  • Valdosta, GA
  • NPI 1992062426
  Medicare reassignment NPD
• Choice Family Medicine, PC

  • Primary Care Clinic/Center
  • Valdosta, GA
  • NPI 1609087469
  NPD (past)

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

{
    "created_epoch": "1672617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1649983958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 BOWENS MILL RD SW",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333926",
            "telephone_number": "912-331-0846",
            "fax_number": "678-792-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 BOWENS MILL RD SW",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333926",
            "telephone_number": "912-331-0846",
            "fax_number": "678-792-4894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "RILEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-02",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET003756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Milhollin
• Abigail Miller, MD
• Brent E Miller, DC
• Stephen R Miller, PT
• William Charles Miller Jr., M.D.
• Margaret S. Minchew, P.A.
• Aretha Mizell
• Joshua Brett Mizell, D.C.
• Mobleys Discount Pharmacy Inc
• Mihai Mocanu, O.D.

• Speech-Language Pathologist in Douglas, GA
• Providers in Douglas, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.