Organization Active NPI

Anchored Minds Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Vidalia, GA
National Provider Identifier
1235015579
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ANCHORED MINDS BEHAVIORAL HEALTH LLC
Practice address
121 Church St
Vidalia, GA 30474-4752
Phone
(912) 805-2705
NPI assigned
Aug 13, 2025
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
James CampbellNPI 1851935316
Title
Owner
Phone
(912) 805-2705

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

121 Church St
Vidalia, GA 30474-4752

Mailing address

121 Church St
Vidalia, GA 30474-4752
Phone (912) 805-2705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250926003124 GA Part B Supplier - Clinic/Group Practice 9931604105 Receives reassigned benefits from 1 practitioner
Practice locations: Vidalia, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2343287Anchored Minds Behavioral Health LLC121 Church Street, Vidalia, GA 30474Certificate of waiverMay 4, 2028

National Provider Directory

National Provider Directory

Locations

121 Church St
Vidalia, GA 30474
Phone (912) 537-7737

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1235015579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CHURCH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744752",
            "telephone_number": "912-805-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CHURCH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744752",
            "telephone_number": "912-805-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCHORED MINDS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-805-2705"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.