Individual provider Active NPI

Camara J Minks, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Centreville, VA
National Provider Identifier
1851358113
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202003303 Issued in VA
Practice address
5240 Belle Plains Dr
Centreville, VA 20120-3344
Phone
(703) 655-1448
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202003303 VA Primary

Addresses

Primary practice location

5240 Belle Plains Dr
Centreville, VA 20120-3344

Mailing address

5240 Belle Plains Dr
Centreville, VA 20120-3344
Phone (703) 655-1448

Other identifiers 1

IdentifierTypeStateIssuer
47065477700MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2202003303VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1851358113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 BELLE PLAINS DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201203344",
            "telephone_number": "703-655-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 BELLE PLAINS DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201203344",
            "telephone_number": "703-655-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKS",
        "first_name": "CAMARA",
        "middle_name": "J",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065477700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.