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JAI MIMMACK
NPI 1104755883
Student in an Organized Health Care Education/Training Program in Mitchell, SD

Active since May 18, 2026
1809 N WISCONSIN ST, MITCHELL, SD 57301(605) 990-3733(605) 990-3733 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jai Mimmack NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAI MIMMACK (NPI 1104755883) is an individual student in an organized health care education/training program in Mitchell, South Dakota and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1104755883
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJAI MIMMACK
Location Address1809 N WISCONSIN STMitchell, SD 57301-1067
Mailing Address1809 N Wisconsin StMitchell, SD 57301-1067 · (605) 990-3733 · Fax (605) 990-3733
Phone(605) 990-3733
Fax(605) 990-3733
Sole ProprietorNo
Enumeration DateMay 18, 2026
NPPES CertifiedMay 18, 2026
✔ NPI 1104755883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1809 N WISCONSIN ST, Mitchell, SD 57301
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANCHOR'D RECOVERY, INC
Clinic/Center (Rehabilitation, Substance Use Disorder)
1809 N WISCONSIN ST
MITCHELL, SD 57301
Davison County (605) 990-3733
BENNY MEDRANO
Student in an Organized Health Care Education/Training Program
1809 N WISCONSIN ST
MITCHELL, SD 57301
Davison County (605) 990-3733

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jai Mimmack's NPI number?

The NPI number for Jai Mimmack is 1104755883. It was assigned to this individual provider in the NPPES registry on May 18, 2026.

Where is Jai Mimmack located?

Jai Mimmack practices at 1809 N Wisconsin St, Mitchell, SD 57301. The listed phone number is (605) 990-3733.

What is Jai Mimmack's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jai Mimmack was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.