NPIMap

Organization Active NPI

The Mia Center LLC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Medford, NY
National Provider Identifier
1679242002
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
Legal business name
THE MIA CENTER LLC
Practice address
12 Platinum CT Ste C
Medford, NY 11763-2247
Phone
(631) 996-4430
NPI assigned
Sep 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Authorized official

Name
Karen Constance Field, PNPNPI 1497902506
Title
Owner
Phone
(631) 996-4430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0809X Primary

Addresses

Primary practice location

12 Platinum CT Ste C
Medford, NY 11763-2247

Mailing address

12 Platinum CT Ste C
Medford, NY 11763-2247
Phone (631) 996-4430

Other identifiers 1

IdentifierTypeStateIssuer
1497902506MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address zimmerlyc@optonline.net Direct
Direct Messaging Address zimmerlyc@optonline.net Direct

National Provider Directory

National Provider Directory

Locations

12 Platinum Ct
Ste C
Medford, NY 11763
Phone (631) 996-4430

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1679242002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PLATINUM CT STE C",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632247",
            "telephone_number": "631-996-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PLATINUM CT STE C",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632247",
            "telephone_number": "631-996-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MIA CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "FIELD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "CONSTANCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-996-4430",
        "authorized_official_credential": "PNP"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497902506",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zimmerlyc@optonline.net",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12 Platinum Ct Ste C",
            "city": "Medford",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117632247",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zimmerlyc@optonline.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12 Platinum Ct Ste C",
            "city": "Medford",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117632247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.