The Mind Store, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

THE MIND STORE, LLC

Practice address

10099 Ridgegate Pkwy Ste 420
Lone Tree, CO 80124-5536

Phone

(303) 800-6463

Fax

(303) 500-6585

NPI assigned

Apr 11, 2022

Last updated

Jan 31, 2024By 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

Dr. Hy Gia Young Park, MDNPI 1649444829

Title

Managing Partner

Phone

(720) 209-8537

Specialties & licenses 2

Addresses

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

CLIA laboratory certificates

Locations

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.

• Hy Gia Young Park, MPH, MS, MD

  • Psychiatry Physician
  • Lone Tree, CO
  • NPI 1649444829
  NPD Authorized official

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1437891348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10099 RIDGEGATE PKWY STE 420",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245536",
            "telephone_number": "303-800-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10099 RIDGEGATE PKWY STE 420",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245536",
            "telephone_number": "303-800-6463",
            "fax_number": "303-500-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MIND STORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-11",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "HY GIA",
        "authorized_official_middle_name": "YOUNG",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "720-209-8537",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.