Myndfull Care Michigan PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MYNDFULL CARE MICHIGAN PC

Practice address

5930 Lovers LN Ste L1
Portage, MI 49002-1673

Phone

(855) 839-8878

NPI assigned

Oct 18, 2022

Last updated

Jan 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teja SinghNPI 1205875606

Title

Owner/MD

Phone

(855) 839-8878

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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.

• Teja Singh Jr., M.D.

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1205875606

  MI

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1053037382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9436 W LAKE MEAD BLVD",
            "address_2": "SUITE 5 PMB 1113",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 LOVERS LN STE L1",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021673",
            "telephone_number": "855-839-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYNDFULL CARE MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "TEJA",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "855-839-8878"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Remnant Mwanahiba, MD
• Kennedy Opiyo Mwanda
• Brett Andrew Myers, DC
• Myeyedr Optometry of Michigan, LLC (RX Optical)
• Myndfull Care Management Michigan PC
• Nadine Fish Inc
• Paula Rose Nagy
• Sydney Nardizzi
• Amber Rachelle Nash-Guilford, D.O.
• Amy Elizabeth Naugle, PH.D.

• Family Medicine Physician in Portage, MI
• Providers in Portage, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.