Organization Active NPI

Mindfulhealth, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1063187508
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDFULHEALTH, LLC
Practice address
1390 29TH Ave Ste B
Gulfport, MS 39501-1945
Phone
(228) 865-1330
NPI assigned
Aug 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Authorized official

Name
Ramona Girley, NPNPI 1437648854
Title
Owner
Phone
(707) 290-7944

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1390 29TH Ave Ste B
Gulfport, MS 39501-1945

Mailing address

1390 29TH Ave Ste B
Gulfport, MS 39501-1945

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210928001214 MS Part B Supplier - Clinic/Group Practice 1355748724 Receives reassigned benefits from 1 practitioner
Practice locations: Gulfport, MS

National Provider Directory

National Provider Directory

Locations

1390 29th Ave
#B
Gulfport, MS 39501
Phone (228) 220-4226

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": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1063187508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 29TH AVE STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395011945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 29TH AVE STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395011945",
            "telephone_number": "228-865-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULHEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "GIRLEY",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-290-7944",
        "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": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.