Organization Active NPI

Elevated Minds Psychiatry Services

  • Psychiatry Physician
  • Tallahassee, FL
National Provider Identifier
1033896659
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ELEVATED MINDS PSYCHIATRY SERVICES
Practice address
4750 Capital Cir SE
Tallahassee, FL 32311-7837
Phone
(850) 429-4501
Fax
(850) 789-1975
NPI assigned
Jul 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Heather Redena Warren, PMHNP-BCNPI 1992202659
Title
Aprn
Phone
(850) 688-7217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4750 Capital Cir SE
Tallahassee, FL 32311-7837

Mailing address

4750 Capital Cir SE
Tallahassee, FL 32311-7837
Phone (850) 429-4501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240731000380 FL Part B Supplier - Clinic/Group Practice 8022555754 Receives reassigned benefits from 1 practitioner
Practice locations: Tallahassee, FL

National Provider Directory

National Provider Directory

Locations

4750 Capital Cir SE
Tallahassee, FL 32311
Phone (850) 408-8496

Practitioners & affiliated clinicians

Practitioners 1

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": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1033896659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 CAPITAL CIR SE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323117837",
            "telephone_number": "850-429-4501",
            "fax_number": "850-789-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 CAPITAL CIR SE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323117837",
            "telephone_number": "850-429-4501",
            "fax_number": "850-789-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATED MINDS PSYCHIATRY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "REDENA",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "850-688-7217",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.