Healthy Minds and Wellness

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

HEALTHY MINDS AND WELLNESS

Practice address

2330 Scenic Hwy S Ste 610
Snellville, GA 30078-3115

Phone

(770) 810-5836

NPI assigned

Jan 8, 2025

Organization subpart

No

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

Authorized official

Name

Omar Kevin Fuller, NPNPI 1932833050

Title

Owner

Phone

(973) 572-8260

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Omar Kevin Fuller

  • Psychiatric/Mental Health Nurse Practitioner
  • Loganville, GA
  • NPI 1932833050

  FL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1043020662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SCENIC HWY S STE 610",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SCENIC HWY S STE 610",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783115",
            "telephone_number": "770-810-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY MINDS AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-572-8260",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Snellville, GA
• Providers in Snellville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.