Catherine Johnson Mincy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3009-97 Issued in MS

Practice address

607 W Church St
Booneville, MS 38829-2647

Phone

(662) 728-5199

Fax

(662) 728-6903

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Catherine Johnson Mincy, DDS

  • General Practice Dentistry
  • Booneville, MS
  • NPI 1790801298
  NPD (past) Authorized official
• Charles D. Johnson, DDS

  • General Practice Dentistry
  • Booneville, MS
  • NPI 1629299847
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679627335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODRIDGE DR",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388298294",
            "telephone_number": "662-728-8133",
            "fax_number": "662-728-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W CHURCH ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292647",
            "telephone_number": "662-728-5199",
            "fax_number": "662-728-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINCY",
        "first_name": "CATHERINE",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3009-97",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015740",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Ruth Mercer, PHARMD
• Amanda Paige Michael, ACNPC-AG
• Hunter Scott Michael, RN,MSN, APRN, FNP-BC
• Courtney Lynn Miles
• Brittany Alaina Crowell Miller, AGACNP-BC, FNP-C
• Kelsey Mink, FNP-C
• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy #04536)
• Mississippi State Department of Health (Northeast Home Health Agency 2B)
• Mississippi State Department of Health
• Mockingbird Assisted Living, LLC

• General Practice Dentistry in Booneville, MS
• Providers in Booneville, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.