NPIMap

Organization Active NPI

Mindhealthy PC

  • Multi-Specialty Clinic/Center
  • Morrisville, NC
National Provider Identifier
1003495896
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MINDHEALTHY PC
Practice address
909 Aviation Pkwy Ste 400
Morrisville, NC 27560-6603
Phone
(888) 510-1352
NPI assigned
Apr 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Authorized official

Name
Brooke Gans
Title
Ceo
Phone
(888) 411-1520

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Multi-Specialty Clinic/Center 261QM1300X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

909 Aviation Pkwy Ste 400
Morrisville, NC 27560-6603

Mailing address

909 Aviation Pkwy Ste 400
Morrisville, NC 27560-6603
Phone (888) 510-1352

Other practice location 1

5664 Bee Ridge Rd Ste 203
Sarasota, FL 34233-1504
Phone (888) 510-1352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210625002649 NC Part B Supplier - Clinic/Group Practice 4284035353 Receives reassigned benefits from 3 practitioners
Practice locations: Morrisville, NC
O20211111000178 FL Part B Supplier - Clinic/Group Practice 4284035353 Receives reassigned benefits from 3 practitioners
Practice locations: Tallahassee, FL

National Provider Directory

National Provider Directory

Locations

909 Aviation Pkwy
Ste 400
Morrisville, NC 27560
Phone 8333755300141

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1003495896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 AVIATION PKWY STE 400",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275606603",
            "telephone_number": "888-510-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 AVIATION PKWY STE 400",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275606603",
            "telephone_number": "888-510-1352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5664 Bee Ridge Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342331504",
            "country_code": "US",
            "telephone_number": "888-510-1352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDHEALTHY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "GANS",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-411-1520"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.