Modern Mindcare PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MODERN MINDCARE PLLC

Practice address

1985 W 33Rd St
Edmond, OK 73013-3875

Phone

(405) 633-2496

Fax

(224) 935-4482

NPI assigned

Feb 20, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Shyvonne Gray, MD

Title

Owner

Phone

(405) 633-2496

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1013473560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 W 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133875",
            "telephone_number": "405-633-2496",
            "fax_number": "224-935-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 W 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133875",
            "telephone_number": "405-633-2496",
            "fax_number": "224-935-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MINDCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "SHYVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-633-2496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MM Health Aprn-CNP PLLC
• Jeremy Brandon Moad, M.D
• Mobile Therapy Services
• Brittany Donelle Mobley, LMT
• Modern Concierge Medicine
• Modernday Housecall
• Darlene Moehnke, M.ED
• Amy Moffeit
• Sandra C. Mold, L.P.C.
• Alyssa Justine Molina

• Psychiatry Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Psychiatry Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.