Organization Active NPI

Wise Minds by Rhea PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Rapids, MN
National Provider Identifier
1407620453
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WISE MINDS BY RHEA PLLC
Practice address
1255 S Pokegama Ave Unit 11
Grand Rapids, MN 55744-4208
Phone
(218) 999-0018
Fax
(218) 999-9627
NPI assigned
Nov 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Rhea Lou Del Rosario, PMHNPNPI 1336789916
Title
Ceo, Pmhnp
Phone
(218) 999-0018

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1255 S Pokegama Ave Unit 11
Grand Rapids, MN 55744-4208

Mailing address

1255 S Pokegama Ave Unit 11
Grand Rapids, MN 55744-4208
Phone (218) 999-0018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240112003480 MN Part B Supplier - Clinic/Group Practice 8921459009 Receives reassigned benefits from 2 practitioners
Practice locations: Grand Rapids, MN

National Provider Directory

National Provider Directory

Locations

1255 S Pokegama Ave
Unit 11
Grand Rapids, MN 55744
Phone (218) 398-9347

Practitioners & affiliated clinicians

Practitioners 2

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": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1407620453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 S POKEGAMA AVE UNIT 11",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557444208",
            "telephone_number": "218-999-0018",
            "fax_number": "218-999-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 S POKEGAMA AVE UNIT 11",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557444208",
            "telephone_number": "218-999-0018",
            "fax_number": "218-999-9627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MINDS BY RHEA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "DEL ROSARIO",
        "authorized_official_first_name": "RHEA LOU",
        "authorized_official_title_or_position": "CEO, PMHNP",
        "authorized_official_telephone_number": "218-999-0018",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.

Verify at the official NPI Registry.