Mind Rebirth PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MIND REBIRTH PLLC

Practice address

3923 Ridgedale St
Memphis, TN 38127-4036

Phone

(901) 208-6984

NPI assigned

Jul 29, 2022

Organization subpart

No

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

Authorized official

Name

Miss Vickie Michelle Johnson, MASTERSNPI 1922338086

Title

Nurse Practitioner

Phone

(901) 208-6984

Specialties & licenses 1

Addresses

Tax ID family

Mind Rebirth PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mind Rebirth PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
  • NPI 1457089880
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vickie M Johnson, NURSE PRACTITIONER

  • Nurse Practitioner
  • Novi, MI
  • NPI 1922338086

  Psychiatric/Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1144956392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3923 RIDGEDALE ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381274036",
            "telephone_number": "901-208-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3923 RIDGEDALE ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381274036",
            "telephone_number": "901-208-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND REBIRTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "901-208-6984",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MASTERS"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee P Miltich, PHD
• Cherie Fontenot Mims, DPH
• Kellie Mims
• Elizabeth Harvey Min, FNP-C
• Gayle Minard, MD
• Mind Rebirth PLLC
• Mind Renewals Inc
• Jason Gerald Minderman, CTRS
• Mindful Horizon Mental Health LLC
• Minding Your Mental Health LLC

• Psychiatric/Mental Health Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.