Mimo Medical Services, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MIMO MEDICAL SERVICES, LLC

Practice address

2506 Crestview Dr
Magnolia, AR 71753-4336

Phone

(479) 530-1308

Fax

(479) 968-1673

NPI assigned

Sep 2, 2020

Organization subpart

No

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

Authorized official

Name

Mathias Groguhe

Title

Managing Employee

Phone

(512) 201-6766

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mimo Rose Lemdja, M.D.

  • Family Medicine Physician
  • Camden, AR
  • NPI 1023283710
  Medicare reassignment

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771977600000",
    "number": "1871107474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "800-824-4094",
            "fax_number": "479-968-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 CRESTVIEW DR",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717534336",
            "telephone_number": "479-530-1308",
            "fax_number": "479-968-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIMO MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A",
        "authorized_official_last_name": "GROGUHE",
        "authorized_official_first_name": "MATHIAS",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "512-201-6766"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.