Modern Alchemy Integrative Women's Health, PLLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

MODERN ALCHEMY INTEGRATIVE WOMEN'S HEALTH, PLLC

Practice address

220A E Front St
New Bern, NC 28560-2146

Phone

(252) 626-4401

NPI assigned

Nov 24, 2020

Last updated

Jan 11, 2021By 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

Heather Marie Truog, OTD, OTR/LNPI 1790185585

Title

Owner

Phone

(269) 760-7867

Specialties & licenses 2

Addresses

Electronic endpoints 1

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.

• Heather Marie Truog, OTD, OTR/L

  • Occupational Therapist
  • New Bern, NC
  • NPI 1790185585
  NPD Authorized official

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1306440953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SHOREVIEW DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285626611",
            "telephone_number": "269-760-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220A E FRONT ST",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285602146",
            "telephone_number": "252-626-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Shoreview Dr",
            "address_purpose": "LOCATION",
            "city": "New Bern",
            "state": "NC",
            "postal_code": "285626611",
            "country_code": "US",
            "telephone_number": "269-760-7867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODERN ALCHEMY INTEGRATIVE WOMEN'S HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-24",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "TRUOG",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-760-7867",
        "authorized_official_credential": "OTD, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "JaneApp.com",
            "affiliation": "N",
            "endpointDescription": "HIPPA compliant software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "220A E Front St",
            "city": "New Bern",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285602146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Olivia Mitchell, LCSW-A, LCAS-A
• Samantha Mitchell, PTA
• Jasmine Mixon
• Craig Mize, D.D.S
• Christopher B Mizelle, MD
• Barbara Darlene Modlin
• Casey Moeck
• Peggie Collins Moffitt
• Ala Mohamedelhassan
• Anita Elizabeth Mohanty-Barnes, LCSW

• Rehabilitation Clinic/Center in New Bern, NC
• Providers in New Bern, NC by specialty
• Rehabilitation Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.