Mindset Healthcare, PC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MINDSET HEALTHCARE, PC

Practice address

135 Bradford SQ Ste B
Fayetteville, GA 30215-1902

Phone

(470) 646-3738

Fax

(888) 910-6463

NPI assigned

Sep 28, 2018

Last updated

Apr 25, 2023By 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

Omolola A OtubagaNPI 1033595566

Title

Aprn-BC/Nurse Practioner

Phone

(404) 444-1904

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 4

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.

• Omolola Otubaga, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, GA
  • NPI 1033595566
  Medicare reassignment Care Compare group NPD Authorized official
• Douglas Thurman Cooper, M.D.

  • Psychiatry Physician
  • Brunswick, GA
  • NPI 1255495131
  Medicare reassignment Care Compare group NPD
• Tianna Cosima Crooks, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, GA
  • NPI 1093509028
  Medicare reassignment NPD
• Samantha Gwen Hudson, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Senoia, GA
  • NPI 1003701889
  Medicare reassignment NPD

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1285119925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5465 HIGHWAY 42 UNIT 246",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302944042",
            "telephone_number": "470-646-3738",
            "fax_number": "888-910-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 BRADFORD SQ STE B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302151902",
            "telephone_number": "470-646-3738",
            "fax_number": "888-910-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDSET HEALTHCARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-28",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "OTUBAGA",
        "authorized_official_first_name": "OMOLOLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "APRN-BC/NURSE PRACTIONER",
        "authorized_official_telephone_number": "404-444-1904"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Milsap, PSYD, LPC
• Mimi Cares Personal Care LLC (MIMI Cares Personal Care)
• Mind-Head Solutions, LLC (Verity Counseling & Forensic Evaluations)
• Mindful Alternatives, Inc.
• Mindfull Strategies, LLC
• Beverlyn Ming
• April Jordan Mitchell, FNP-C
• Barbara Grady Mitchell, DDS
• Carlton Wendell Mitchell, LPC (PLLC)
• Stacey Lasandra Mitchell, NP

• Psychiatric/Mental Health Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.