Mary Mims

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

67774 Issued in TX

Practice address

2626 S Clack St
Abilene, TX 79606-1557

Phone

(325) 690-5100

Fax

(325) 691-2035

NPI assigned

Apr 23, 2014

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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• Abilene Regional MHMR Center

  • Developmental Disabilities Clinic/Center
  • Abilene, TX
  • NPI 1699741975

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1689094146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 S CLACK ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061557",
            "telephone_number": "325-690-5100",
            "fax_number": "325-691-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 S CLACK ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061557",
            "telephone_number": "325-690-5100",
            "fax_number": "325-691-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Milliorn, LMSW-IPR
• Shannon Renae Milliorn
• Destiney Love Mills
• Stephen Milstead, PMHNP
• Wanda Carolyn Milton, LPC, BCBA, LBA
• Molly Graham Minze, PHARM.D.
• Mia Tiffany Aportadera Mira, CRNA
• Miracle Deeds Medical Supplies LLC
• Mister Meds LLC
• Carrie Mitchell

• Professional Counselor in Abilene, TX
• Providers in Abilene, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.