Individual provider Active NPI

Alicia Mimms, FNP-BC

  • Family Nurse Practitioner
  • Corpus Christi, TX
National Provider Identifier
1679346100
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1020397 Issued in TX
Practice address
7629 S Staples St Ste 106a
Corpus Christi, TX 78413-5388
Phone
(361) 238-0015
NPI assigned
Nov 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1020397 TX Primary

Addresses

Primary practice location

7629 S Staples St Ste 106a
Corpus Christi, TX 78413-5388

Mailing address

7629 S Staples St Ste 106a
Corpus Christi, TX 78413-5388
Phone (361) 238-0015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1020397TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
QC Professional PLLC CurrentSince May 1, 2024 Accepting new patients
QC Urgent Care PLLC CurrentSince May 1, 2024 Accepting new patients

Locations

7629 S Staples St
Unit 106A
Corpus Christi, TX 78413
Phone (361) 888-2820

1290 FM 43
Ste J
Corpus Christi, TX 78415
Phone (361) 238-0015

7629 S Staples St
Ste 106A
Corpus Christi, TX 78413
Phone (361) 238-0015

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1679346100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7629 S STAPLES ST STE 106A",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784135388",
            "telephone_number": "361-238-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7629 S STAPLES ST STE 106A",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784135388",
            "telephone_number": "361-238-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMMS",
        "first_name": "ALICIA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1020397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.