AMANDA MIMS (MSN, AGNP-C) – Nurse Practitioner, NPI 1821712415

AMANDA MIMS (MSN, AGNP-C) is a healthcare provider. based in Dallas, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN, AGNP-C. They hold a License No. 1-155145 (AL). The NPI Number for AMANDA MIMS (MSN, AGNP-C) is 1821712415

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA MIMS (MSN, AGNP-C)
NPI
1821712415
Phone
(855) 984-5121
Address
4055 VALLEY VIEW LN STE 700
Enumeration Date
28 September 2022
Last Update Date
28 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2514508044
Graduation Year
2022 (4 years ago)
PAC ID
4082083761
Group Practice PAC ID
2860670494
Professional Enrollment ID
I20231121002828
Address ID
AL366091987MO3929XBLVD313
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for AMANDA MIMS (MSN, AGNP-C)

  • 4055 VALLEY VIEW LN STE 700

    DALLAS, TX 752445045

    Phone: (855) 984-5121

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $102.

Total Amount is formed as General ($102) + Research ($0) + Ownership ($0) = $102.

Last reported payment date: 2024-10-31 • Largest payer in this snapshot: Atland Pharmaceuticals, LLC ($52).

Total Amount

$102

General + Research + Ownership

Payments

4

Total payment records

General Amount

$102

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-31

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221220002112INurse PractitionerFLTBD
I20231121002828INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75244)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860670494View full group profile
NameSpecialtyState
Physical Medicine And RehabilitationAL
Nurse PractitionerAL

Reviews

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Frequently asked questions

What NPI should I save for AMANDA MIMS (MSN, AGNP-C)?
Save NPI 1821712415 if you need a stable reference for AMANDA MIMS (MSN, AGNP-C).
Does this profile mean AMANDA MIMS (MSN, AGNP-C) is currently active?
Yes — AMANDA MIMS (MSN, AGNP-C) appears active in the national provider directory.
Can you summarize AMANDA MIMS (MSN, AGNP-C)'s specialty in plain language?
Clinically, the directory lists AMANDA MIMS (MSN, AGNP-C) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is AMANDA MIMS (MSN, AGNP-C)'s primary listing?
We display Dallas, Texas because that is what the record indicates for AMANDA MIMS (MSN, AGNP-C).
Is AMANDA MIMS (MSN, AGNP-C) a real provider?
This page reflects official NPPES data for NPI 1821712415. Always confirm identity and privileges with the practice and licensing boards.

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