The Mind Body Collaborative

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

THE MIND BODY COLLABORATIVE

Doing business as

The Mind-Body Collaborative, Inc.

Practice address

3811 Bee Caves Rd Ste 204
West Lake Hills, TX 78746-6459

Phone

(737) 256-7801

NPI assigned

Mar 30, 2022

Last updated

Mar 30, 2022By 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

Mr. James A Conklin

Title

Chief Financial Officer/Co-Founder

Phone

(737) 256-7801

Specialties & licenses 1

Addresses

Other names 1

• The Mind-Body Collaborative, Inc. Doing business as

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1083354914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 BEE CAVES RD STE 204",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787466459",
            "telephone_number": "737-256-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 BEE CAVES RD STE 204",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787466459",
            "telephone_number": "737-256-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MIND BODY COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER/CO-FOUNDER",
        "authorized_official_telephone_number": "737-256-7801",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Mind-Body Collaborative, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.