Brittany Dawn Mims, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-03690 Issued in NC

Practice address

3213 Rogers Rd
Wake Forest, NC 27587-3805

Phone

(919) 562-2288

Fax

(919) 562-2225

NPI assigned

Aug 14, 2012

Last updated

Jun 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Brittany Dawn Mims Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bblackburn@goshenmedical.cloudcraftdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Goshen Medical Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Faison, NC
  • NPI 1154378933
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Village Family Care

  • Family Medicine Physician
  • Wake Forest, NC
  • NPI 1659571768
  NPD (past)

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1972850410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 ROGERS RD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873805",
            "telephone_number": "919-562-2288",
            "fax_number": "919-562-2225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2906 N Main St",
            "address_purpose": "LOCATION",
            "city": "Tarboro",
            "state": "NC",
            "postal_code": "278861921",
            "country_code": "US",
            "telephone_number": "252-823-7212",
            "fax_number": "252-823-5668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Patrick Ct",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "27804",
            "country_code": "US",
            "telephone_number": "252-443-0400",
            "fax_number": "252-443-0572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13304 Leesville Church Rd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276175206",
            "country_code": "US",
            "telephone_number": "919-845-5276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIMS",
        "first_name": "BRITTANY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bblackburn844821@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3213 Rogers Rd",
            "city": "Wake Forest",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275873805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "MIMS",
            "middle_name": "DAWN",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Ashley Mills, MS, LCMHCA
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• Mind & Mane LLC
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• Mindscape ABA and Educational Services

• Physician Assistant in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.