1. Home
  2. Directory
  3. Kentucky
  4. Louisville
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

AMELIA MIMMS MD
NPI 1619611910
Student in an Organized Health Care Education/Training Program in Louisville, KY

Active since April 22, 2022PECOS Enrolled
530 S JACKSON ST RM C1H17, LOUISVILLE, KY 40202(502) 852-5689 Get Directions Write a Review

NPPES record last updated: April 26, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Amelia Mimms Md NPPES

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

AMELIA MIMMS MD (NPI 1619611910) is an individual student in an organized health care education/training program in Louisville, Kentucky and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619611910
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameAMELIA MIMMSCredential: MD
Location Address530 S JACKSON ST RM C1H17Louisville, KY 40202-1675
Mailing Address530 S Jackson St Rm C1h17Louisville, KY 40202-1675 · (502) 852-5689
Phone(502) 852-5689
Sole ProprietorNo
Enumeration DateApril 22, 2022
Last NPPES UpdateApril 26, 2025
NPPES CertifiedApril 25, 2025
✔ NPI 1619611910 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.
530 S JACKSON ST RM C1H17, Louisville, KY 40202
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amelia Mimms Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

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

DR. LANDEN PEHLE DO
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
LAUREN RAE GRECO
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
SYDNEY GRONEMEYER
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
HANNAH HUDSON
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
SETH BENJAMIN BALLEW
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (256) 612-8636
ETHAN ZASTERA DO
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
SULLIVAN SCOTT SMITH DO
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
JENNA CHADY
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689

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 Amelia Mimms's NPI number?

The NPI number for Amelia Mimms is 1619611910. It was assigned to this individual provider in the NPPES registry on April 22, 2022.

Where is Amelia Mimms located?

Amelia Mimms practices at 530 S Jackson St Rm C1h17, Louisville, KY 40202. The listed phone number is (502) 852-5689.

What is Amelia Mimms's specialty?

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

Is Amelia Mimms enrolled in Medicare?

Yes. Amelia Mimms is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Amelia Mimms was last updated on April 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.