Persevere Wellness LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

PERSEVERE WELLNESS LLC

Practice address

12488 74TH Ave N
Maple Grove, MN 55369-5285

Phone

(763) 267-2015

NPI assigned

Aug 11, 2022

Organization subpart

No

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

Authorized official

Name

Tracy Mindiola, RDLD

Title

Dietitian

Phone

(763) 267-2015

Specialties & licenses 1

Addresses

Other names 1

• Persevere Wellness LLC Doing business as

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1003544602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 GROVE DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553114689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12488 74TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695285",
            "telephone_number": "763-267-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSEVERE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "MINDIOLA",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "763-267-2015",
        "authorized_official_credential": "RDLD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Persevere Wellness LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Ann Pelkey, OTR/L
• Michelle K. Pemble-Frazey, PHD
• Christine I Pena, L.M.F.T.
• Leighton Michael Penn
• Nina Rachel Perdue, M.D.
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• Beth Ann Pesta, PT
• Laura Linn Peters, LPCC
• Petersen Chiropractic Inc.
• Gregory Joseph Petersen, D.C.

• Registered Dietitian in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.