Martenia Mims, LPN BSHCM MSHS

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN09927 Issued in RI

Practice address

619 Benham St
Hamden, CT 06514-2656

Phone

(475) 655-4159

NPI assigned

Nov 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• My'Racle Hands

  • Home Health Aide
  • Hamden, CT
  • NPI 1588276844
  NPD Authorized official

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1871259606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 BENHAM ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142656",
            "telephone_number": "475-655-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 BENHAM ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142656",
            "telephone_number": "475-655-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "MARTENIA",
        "credential": "LPN BSHCM MSHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "204554",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "RI",
            "license": "LPN09927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleonora Miller, LCSW
• Perry Miller
• Rebecca Culler Miller, L.C.S.W.
• Robert Harold Miller
• Ellen Block Milstone, M.D.
• Mindful Balance Therapy LLC
• Alexandra Marvel Miranda-Castillo, LMFT
• Danielle Kristen Miranda
• Diane Karen Mital
• Hayes Mitchell, LPCA

• Licensed Practical Nurse in Hamden, CT
• Providers in Hamden, CT by specialty
• Licensed Practical Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.