Organization Active NPI

Modern Mentality Ventures, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Marshfield, MA
National Provider Identifier
1366292864
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MODERN MENTALITY VENTURES, PLLC
Practice address
892 Plain St Ste 1
Marshfield, MA 02050-2191
Phone
(781) 803-7757
NPI assigned
Mar 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
James Kennedy, NPNPI 1508593807
Title
Nurse Practitioner
Phone
(781) 803-7757

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

892 Plain St Ste 1
Marshfield, MA 02050-2191

Mailing address

892 Plain St Ste 1
Marshfield, MA 02050-2191

National Provider Directory

National Provider Directory

Locations

892 Plain St
Ste 1
Marshfield, MA 02050
Phone (781) 277-0699

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1366292864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "892 PLAIN ST STE 1",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020502191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 PLAIN ST STE 1",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020502191",
            "telephone_number": "781-803-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MENTALITY VENTURES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "781-803-7757",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.