Individual provider Active NPI

Vincent Mikula, NP

  • Family Nurse Practitioner
  • Warren, OH
National Provider Identifier
1851911655
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CMP.026652 Issued in OH
Practice address
1615 N River Rd NE
Warren, OH 44483-2437
Phone
(330) 372-2333
NPI assigned
Apr 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CMP.026652 OH Primary

Addresses

Primary practice location

1615 N River Rd NE
Warren, OH 44483-2437

Mailing address

1615 N River Rd NE
Warren, OH 44483-2437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200529002653 OH Practitioner - Nurse Practitioner 8325469356 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CMP.026652OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Justin P. Mikula, M.D., Inc. CurrentSince Jun 1, 2020 Accepting new patients

Locations

1615 N River Rd NE
Warren, OH 44483
Phone (330) 372-2333

1350 E Market St
Warren, OH 44483
Phone (330) 841-5969

1615 N River Rd NE
#1
Warren, OH 44483
Phone (330) 372-2333

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1851911655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 N RIVER RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 N RIVER RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832437",
            "telephone_number": "330-372-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULA",
        "first_name": "VINCENT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CMP.026652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.