Active NPI
Empoweing Minds Body @Wellness Center LLC
- Family Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1073335956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- EMPOWEING MINDS BODY @WELLNESS CENTER LLC
- Doing business as
- Empowering Minds Body @ Wellness Center LLC
- Practice address
- 2828 N Central Ave Ste 803
Phoenix, AZ 85004-1021 - Phone
- (404) 610-1236
- Fax
- (855) 300-5330
- NPI assigned
- Oct 30, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Varonica Freeman
- Title
- Manager
- Phone
- (513) 260-9643
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
2828 N Central Ave Ste 803
Phoenix, AZ 85004-1021
Mailing address
2828 N Central Ave Ste 803
Phoenix, AZ 85004-1021
Phone (404) 610-1236
Other names 1
- Empowering Minds Body @ Wellness Center LLC
National Provider Directory
National Provider DirectoryLocations
2828 N Central Ave
Ste 803
Phoenix, AZ 85004
Phone (404) 610-1236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730246400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1730246400000",
"number": "1073335956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2828 N CENTRAL AVE STE 803",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850041021",
"telephone_number": "404-610-1236",
"fax_number": "855-300-5330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2828 N CENTRAL AVE STE 803",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850041021",
"telephone_number": "404-610-1236",
"fax_number": "855-300-5330"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMPOWEING MINDS BODY @WELLNESS CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-30",
"last_updated": "2024-10-30",
"certification_date": "2024-10-30",
"status": "A",
"authorized_official_last_name": "FREEMAN",
"authorized_official_first_name": "VARONICA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "513-260-9643"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Empowering Minds Body @ Wellness Center LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.