NPIMap

Organization Active NPI

Mindful Innovations

  • Psychiatric/Mental Health Nurse Practitioner
  • High Point, NC
National Provider Identifier
1043975048
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDFUL INNOVATIONS
Practice address
4154 Mendenhall Oaks Pkwy Ste 103
High Point, NC 27265-8034
Phone
(336) 847-1626
NPI assigned
Nov 3, 2021
Reactivated
Aug 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Authorized official

Name
Crystal Jenita MontagueNPI 1669887774
Title
Ceo
Phone
(336) 847-1626

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

4154 Mendenhall Oaks Pkwy Ste 103
High Point, NC 27265-8034

Mailing address

1155 Double Pond LN
High Point, NC 27265-9242
Phone (336) 847-1626

Other practice location 1

1981 Eastchester Drive
High Point, NC 27265
Phone (336) 905-8011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211208000010 NC Part B Supplier - Clinic/Group Practice 0547650475 Receives reassigned benefits from 8 practitioners
Practice locations: High Point, NC

National Provider Directory

National Provider Directory

Locations

4154 Mendenhall Oaks Pkwy
Ste 103
High Point, NC 27265
Phone (336) 847-1626

Practitioners & affiliated clinicians

Practitioners 11

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": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1043975048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 DOUBLE POND LN",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659242",
            "telephone_number": "336-847-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4154 MENDENHALL OAKS PKWY STE 103",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658034",
            "telephone_number": "336-847-1626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1981 Eastchester Drive",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "27265",
            "country_code": "US",
            "telephone_number": "336-905-8011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL INNOVATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "deactivation_date": "2023-08-07",
        "reactivation_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "MONTAGUE",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "JENITA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-847-1626"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

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