NPIMap

Organization Active NPI

Changing Minds Psychiatry LLC

Doing business as Changing Minds Psychiatry

  • Community Health Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1023627734
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
Legal business name
CHANGING MINDS PSYCHIATRY LLC
Doing business as
Changing Minds Psychiatry
Practice address
2960 W Horizon Ridge Pkwy
Henderson, NV 89052-4666
Phone
(702) 405-8088
NPI assigned
Jul 28, 2020
Last updated
Oct 24, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CHANGING MINDS PSYCHIATRY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Authorized official

Name
Jamie Brown
Title
Business Manager
Phone
(702) 405-8088

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Community Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC1500X Primary

Addresses

Primary practice location

2960 W Horizon Ridge Pkwy
Henderson, NV 89052-4666

Mailing address

PO Box 752003
Las Vegas, NV 89136-2003
Phone (702) 405-8088

Other names 1

  • Changing Minds Psychiatry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Changing Minds Psychiatry LLC4 organizations share this tax ID, including this one
Part of
Changing Minds Psychiatry LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1070 Wigwam Pkwy
Ste 120
Henderson, NV 89074

2960 W Horizon Ridge Pkwy
Henderson, NV 89052
Phone (702) 677-1104

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1023627734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 752003",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891362003",
            "telephone_number": "702-405-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524666",
            "telephone_number": "702-405-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING MINDS PSYCHIATRY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHANGING MINDS PSYCHIATRY LLC",
        "enumeration_date": "2020-07-28",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "702-405-8088"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Changing Minds Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Changing Minds Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.