MR. JAMES ROBERT MYNATT (NPI# 1588815021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588815021 |
| Entity Type | Individual |
| Full Name | MR. JAMES ROBERT MYNATT |
| Other Name | JAMES MYNATT |
| Credential | FNP |
| Practice Address |
333 Revolutionary Trail Fairfax SC 29827 |
| Mailing Address |
86 Wren St Barnwell SC 29812 |
| Practice Telephone | 8036322533 |
| Practice Fax Number | 8036322451 |
| Mailing Telephone | 8032595762 |
| Mailing Fax Number | 8032593250 |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2017-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F1512 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP0589 | 05 |
| Street Address |
333 REVOLUTIONARY TRAIL |
| City | FAIRFAX |
| State | SC |
| Zip Code | 29827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588623540 | Rebecca Lynn Wilkes | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-03-20 |
| 1063607646 | Mol Ky | General Practice | 333 Revolutionary Trail, Fairfax, SC 29827 | 2007-09-07 |
| 1073691002 | Robert M Jones | Family Medicine | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-11-01 |
| 1205840733 | Rossie Reid | Social Worker | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467843078 | We Care Family Resource LLC | Point of Service | 513 Bayshore Dr., Fairfax, SC 29827 | 2015-02-18 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1144370503 | Allendale County Hospital Board | Clinic/Center | 1787 Allendale Fairfax Highway, Fairfax, SC 29827 | 2007-01-10 |
| 1336246677 | Allendale County Hospital Board | Skilled Nursing Facility | 185 Revolutionary Trail, Fairfax, SC 29827 | 2006-09-20 |
| 1881646669 | Shenika L. Marshall-hill | Counselor | 1594 Beaufort Ave. S., Fairfax, SC 29827 | 2006-05-17 |
| 1497745012 | Robert M Haberkorn | Dentist | 1987 Allendale-fairfax Hwy, Fairfax, SC 29827 | 2005-10-25 |
| 1073575171 | Dva Healthcare Renal Care Inc | Clinic/Center | 1241 Boundry St W, Fairfax, SC 29827-3611 | 2006-04-04 |
| 1811384340 | Marie Moore | Registered Nurse | 894 7th St W, Fairfax, SC 29827-4880 | 2015-04-22 |
| 1528309606 | Portereshice Shunta Brabham | Health Maintenance Organization | 345 Amelia St, Fairfax, SC 29827-5967 | 2013-03-14 |
| 1851811988 | Kelly Futch Wall | Speech-Language Pathologist | 1460 Pocotaligo Rd, Fairfax, SC 29827-6826 | 2017-06-20 |
| Find all providers in zip 29827 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144147 | Emily Turner | Nurse Practitioner | 1099 Main St, Fairfax, VT 05454-9529 | 2020-11-06 |
| 1366041790 | Stephanie Ferber | Nurse Practitioner | 8081 Innovation Park Dr Fl 7, Fairfax, VA 22031-4867 | 2020-10-16 |
| 1578160198 | Northern Virginia Holistic Primary Care | Nurse Practitioner | 10304 Eaton Pl Ste 100, Fairfax, VA 22030-2238 | 2020-10-06 |
| 1821606377 | Lindsay Ann Bruno | Nurse Practitioner | 2921 District Ave Apt 504, Fairfax, VA 22031-2334 | 2020-07-21 |
| 1013534106 | Natalia Castro | Nurse Practitioner | 12817 Hamlet Hill Way, Fairfax, VA 22030-7250 | 2020-07-06 |
| 1629601448 | Lia Hoa Van | Nurse Practitioner | 3811 Glenbrook Rd, Fairfax, VA 22031-3105 | 2020-02-20 |
| 1043850175 | Olga Michelle Zaiter | Nurse Practitioner | 2740 Prosperity Ave Ste 100, Fairfax, VA 22031-4354 | 2020-01-07 |
| 1821650177 | Evelyne Kingori | Nurse Practitioner | 3022 Javier Rd Ste 105a, Fairfax, VA 22031-4646 | 2019-07-07 |
| 1770149726 | Laura E. Diaz | Nurse Practitioner | 3923 Old Lee Hwy Ste 61a, Fairfax, VA 22030-2428 | 2019-05-15 |
| 1295253102 | Mildred J Medrano | Nurse Practitioner | 9229 Arlington Arlington Blvd., Fairfax, VA 22031 | 2017-08-31 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.