Mind and Body Medical Clinic

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

MIND AND BODY MEDICAL CLINIC

Practice address

2216 NW 164TH St Ste a
Edmond, OK 73013-9078

Phone

(405) 285-4755

Fax

(405) 215-3760

NPI assigned

Nov 4, 2018

Organization subpart

No

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

Authorized official

Name

Kelli Leek, APRN-CNS

Title

Co-Owner

Phone

(405) 285-4755

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1541289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541289600000",
    "number": "1497223846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 NW 164TH ST STE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730139078",
            "telephone_number": "405-285-4755",
            "fax_number": "405-215-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 NW 164TH ST STE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730139078",
            "telephone_number": "405-285-4755",
            "fax_number": "405-215-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND AND BODY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-04",
        "last_updated": "2018-11-04",
        "status": "A",
        "authorized_official_last_name": "LEEK",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "405-285-4755",
        "authorized_official_credential": "APRN-CNS"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0301X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Brain Injury Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SN0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Neuroscience",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therin Miller II
• Melissa Milligan, R.D., L.D.
• Trey Milligan, M.D.
• William Douglas Mills, M.D.
• Haley Lee Milton
• Ministries of Jesus
• Kelly Jo Minor
• Minuteclinic Diagnostic of Oklahoma LLC
• Minuteclinic Video Virtual Care, PLLC
• David D. Minyard, DDS

• Neurology Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Neurology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2018; 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.