Active NPI
Mind & Body - Clinical & Chiropractic
- Chiropractor
- Glendale, AZ
National Provider Identifier
1245038702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Legal business name
- MIND & BODY - CLINICAL & CHIROPRACTIC
- Practice address
- 5870 W Thunderbird Rd Ste A7
Glendale, AZ 85306-4657 - Phone
- (602) 730-2665
- NPI assigned
- Mar 3, 2025
- 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
- Brett Lange, DC
- Title
- Owner
- Phone
- (623) 523-9642
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Chiropractor | 111N00000X | Primary |
Addresses
Primary practice location
5870 W Thunderbird Rd Ste A7
Glendale, AZ 85306-4657
Mailing address
14786 W Alexandria Way
Surprise, AZ 85379-4232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Surprise, AZ
- NPI 1689053209
-
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Phoenix, AZ
- NPI 1821141250
-
- Chiropractor
- Surprise, AZ
- NPI 1972597870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740960000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740960000000",
"number": "1245038702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14786 W ALEXANDRIA WAY",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853794232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5870 W THUNDERBIRD RD STE A7",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853064657",
"telephone_number": "602-730-2665"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIND & BODY - CLINICAL & CHIROPRACTIC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-03",
"last_updated": "2025-03-03",
"certification_date": "2025-03-03",
"status": "A",
"authorized_official_last_name": "LANGE",
"authorized_official_first_name": "BRETT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "623-523-9642",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.