Amanda Mims, MSN, AGNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-155145 Issued in AL

Practice address

4055 Valley View LN Ste 700
Dallas, TX 75244-5045

Phone

(855) 984-5121

NPI assigned

Sep 28, 2022

Sex

Female

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 FL, AL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mobile Physical Medicine and WellnessGroup PAC ID 2860670494, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• USA Health HCA Providence Hospital, LLC Hospital, Mobile, AL, CCN 010090

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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.

• Mobile Physical Medicine & Wellness

  • Physical Medicine & Rehabilitation Physician
  • Mobile, AL
  • NPI 1992002356
  Medicare reassignment Care Compare group NPD
• National Family Medical Associates, LLC

  • Primary Care Clinic/Center
  • Tulsa, OK
  • NPI 1477287720
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• USA Health HCA Providence Hospital LLC

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1992489223
  Care Compare affiliation

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1821712415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445045",
            "telephone_number": "855-984-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445045",
            "telephone_number": "855-984-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "AMANDA",
        "credential": "MSN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-155145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Brian Milton, LPC
• Kaylie Milton, PT, DPT
• James S Milvenan, MD
• Mimi'S Wig Boutique
• Mimi'S Wig Boutique
• Edward Mims, MD
• Linda Marie Mims, LPC
• Douglas Min, M.D.
• Erin Yaerin Min
• Kyung Min, PHARM.D

• Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.