Mind & Body Family Practice and Behavioral Health, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MIND & BODY FAMILY PRACTICE AND BEHAVIORAL HEALTH, LLC

Practice address

7519 Wall Triana Hwy
Madison, AL 35757-8327

Phone

(256) 696-5895

Fax

(256) 696-5404

NPI assigned

Dec 12, 2022

Organization subpart

No

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

Authorized official

Name

Tonia Boddie, DNP

Title

Owner

Phone

(256) 696-5895

Specialties & licenses 1

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

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1457062200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2024",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7519 WALL TRIANA HWY",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357578327",
            "telephone_number": "256-696-5895",
            "fax_number": "256-696-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND & BODY FAMILY PRACTICE AND BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "BODDIE",
        "authorized_official_first_name": "TONIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-696-5895",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Madison, AL
• Providers in Madison, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.