Peace of Mind--Beachside

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

ARNP9355262 Issued in FL

Legal business name

PEACE OF MIND--BEACHSIDE

Practice address

198 Vining CT # 5
Ormond Beach, FL 32176-6658

Phone

(386) 256-5553

Fax

(386) 256-5553

NPI assigned

Apr 10, 2018

Organization subpart

No

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

Authorized official

Name

Melissa Gad, APRN

Title

Manager

Phone

(386) 262-5197

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beachside Doing business as

Locations

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1063919637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 VINING CT # 5",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321766658",
            "telephone_number": "386-256-5553",
            "fax_number": "386-256-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 VINING CT # 5",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321766658",
            "telephone_number": "386-256-5553",
            "fax_number": "386-256-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OF MIND--BEACHSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "GAD",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "386-262-5197",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9355262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696567",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beachside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.