Mind Body Spirit Care Clinic Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MIND BODY SPIRIT CARE CLINIC INC

Practice address

9640 Mallard Dr
Mascoutah, IL 62258-2762

Phone

(618) 960-8796

NPI assigned

Nov 23, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Catherine Deanne Marshall, APRN-BC

Title

President-Owner/Provider

Phone

(618) 624-2788

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1104007756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N BROADWAY AVE",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811511",
            "telephone_number": "618-960-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 MALLARD DR",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622582762",
            "telephone_number": "618-960-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY SPIRIT CARE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "DEANNE",
        "authorized_official_title_or_position": "PRESIDENT-OWNER/PROVIDER",
        "authorized_official_telephone_number": "618-624-2788",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN-BC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mascoutah Nursing and Rehab Center LLC
• Mascoutah Rehab and Nursing LLC
• Meredith McFarland
• Kaitlynne Erin McNutt
• Michelle Hippard, DC, LTD
• Carter Mohesky
• Kayla Moll, MSN FNP-C
• Asia Morales
• Brooke Elizabeth Moses, COTA/L
• Nexus at Mascoutah, LLC

• General Practice Physician in Mascoutah, IL
• Providers in Mascoutah, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.