Minomic, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MINOMIC, INC.

Practice address

15810 Gaither Drive, Suite 235, Room 205
Gaithersburg, MD 20877

Phone

(240) 453-6339

NPI assigned

May 26, 2022

Last updated

May 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stewart Walker

Title

President & Director

Phone

(415) 310-6252

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1841938917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 PLATTE STREET - SUITE 400",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15810 GAITHER DRIVE, SUITE 235, ROOM 205",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20877",
            "telephone_number": "240-453-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINOMIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "STEWART",
        "authorized_official_title_or_position": "PRESIDENT & DIRECTOR",
        "authorized_official_telephone_number": "415-310-6252"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demekech Mindaye
• Minds in Motion Children's Center LLC
• Minds in Motion Children's Center LLC
• Minds in Motion Children's Center, LLC
• Isabelle Minkin
• Minuteclinic LLC
• Cheryl Raab Miranian, PHARM.D
• Behzad Mirdamadi, D.D.S.
• Farnoush Mirmiran, DDS
• Mission Autism Clinics LLC

• Clinical Medical Laboratory in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.