NPIMap

Organization Active NPI

Mind and Body Wellness Center Inc.

  • Urgent Care Clinic/Center
  • Johns Creek, GA
National Provider Identifier
1053919225
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MIND AND BODY WELLNESS CENTER INC.
Practice address
10475 Medlock Bridge Rd Ste 820
Johns Creek, GA 30097-4437
Phone
(404) 800-5181
Fax
(404) 800-5797
NPI assigned
Oct 11, 2020
Last updated
Aug 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Moshe Bachar, MDNPI 1669736559
Title
Physician
Phone
(404) 800-5181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

10475 Medlock Bridge Rd Ste 820
Johns Creek, GA 30097-4437

Mailing address

1801 Peachtree St NE Ste 300
Atlanta, GA 30309-1859
Phone (404) 800-5181

Other practice location 1

369 Sandy Springs Circle
Sandy Springs, GA 30328
Phone (404) 800-5181

Other practice location 2

3020 Holcomb Bridge Rd
Norcross, GA 30071-1375
Phone (404) 800-5181

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2214764Mind and Body Wellness Center, PC10475 Medlock Bridge Road, BLDG 800, Suite 820, Johns Creek, GA 30097Certificate of waiverFeb 24, 2027

National Provider Directory

National Provider Directory

Locations

3301 Lenox Square Pkwy NE
Atlanta, GA 30326
Phone (404) 800-8151

2050 Lawrenceville Hwy
Decatur, GA 30033
Phone (404) 325-5300

10475 Medlock Bridge Rd
Ste 820
Johns Creek, GA 30097
Phone (678) 224-8686

3000 Windy Hill Rd SE
Marietta, GA 30067
Phone (404) 936-1470

8318 Pineville Matthews Rd
Charlotte, NC 28226

2900 E Franklin Blvd
Gastonia, NC 28056

Practitioners & affiliated clinicians

Practitioners 9

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": "1602374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1053919225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 PEACHTREE ST NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091859",
            "telephone_number": "404-800-5181",
            "fax_number": "404-800-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 MEDLOCK BRIDGE RD STE 820",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300974437",
            "telephone_number": "404-800-5181",
            "fax_number": "404-800-5797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "369 Sandy Springs Circle",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "30328",
            "country_code": "US",
            "telephone_number": "404-800-5181",
            "fax_number": "404-800-5797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Holcomb Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300711375",
            "country_code": "US",
            "telephone_number": "404-800-5181",
            "fax_number": "404-800-5797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND AND BODY WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-11",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "BACHAR",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "404-800-5181",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.