Active NPI
Mimi Khine, M.D.
- Psychiatry Physician
- Annandale, VA
National Provider Identifier
1891892220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101044508
- Practice address
- 3340 Woodburn Rd
Annandale, VA 22003-1202 - Phone
- (703) 573-0523
- Fax
- (703) 289-2764
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101044508 | VA | Primary |
Addresses
Primary practice location
3340 Woodburn Rd
Annandale, VA 22003-1202
Mailing address
3340 Woodburn Rd
Annandale, VA 22003-1202
Phone (703) 573-0523
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101044508 | VA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arlington County Government Department of Managment & Finance | Past | Accepting new patients | |
| Arlington County Government Department of Managment & Finance | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Arlington, VA
- NPI 1043280415
-
- Emergency Medical Services (Emergency Medicine) Physician
- Arlington, VA
- NPI 1073104832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1891892220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 WOODBURN RD",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220031202",
"telephone_number": "703-573-0523",
"fax_number": "703-289-2764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3340 WOODBURN RD",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220031202",
"telephone_number": "703-573-0523",
"fax_number": "703-289-2764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHINE",
"first_name": "MIMI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101044508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annandale, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.