NPIMap

Organization Active NPI

Mind 247 Practice LLC

  • Long Term Care Pharmacy
  • Phoenix, AZ
National Provider Identifier
1376251371
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MIND 247 PRACTICE LLC
Practice address
2728 N 24TH St
Phoenix, AZ 85008-1050
Phone
(844) 646-3247
Fax
(480) 546-4048
NPI assigned
Nov 8, 2022
Last updated
Nov 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Authorized official

Name
Aisha Lynn Depriest
Title
Director of Credentialing
Phone
(844) 646-3247

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X NU
Institutional Pharmacy 3336I0012X NU
Long Term Care Pharmacy 3336L0003X NU Primary
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

2728 N 24TH St
Phoenix, AZ 85008-1050

Mailing address

1465 N Scottsdale Rd Ste 400
Scottsdale, AZ 85257-3634
Phone (844) 646-3247

National Provider Directory

National Provider Directory
Tax ID family
Mind 247 Practice LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1376251371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 N SCOTTSDALE RD STE 400",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573634",
            "telephone_number": "844-646-3247",
            "fax_number": "480-546-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850081050",
            "telephone_number": "844-646-3247",
            "fax_number": "480-546-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND 247 PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "DEPRIEST",
        "authorized_official_first_name": "AISHA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "844-646-3247"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.