Mind Body Spirit Wellness Inc

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

055194 Issued in GA

Legal business name

MIND BODY SPIRIT WELLNESS INC

Practice address

2801 Buford Hwy NE Ste T65
Atlanta, GA 30329-2145

Phone

(404) 478-9868

NPI assigned

Feb 6, 2012

Organization subpart

No

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

Authorized official

Name

Maiysha Tania Clairborne, MD

Title

President/Ceo

Phone

(404) 478-9868

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1508138561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2484 BRIARCLIFF RD NE STE 22-315",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293011",
            "telephone_number": "404-478-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE STE T65",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292145",
            "telephone_number": "404-478-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY SPIRIT WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-06",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "CLAIRBORNE",
        "authorized_official_first_name": "MAIYSHA",
        "authorized_official_middle_name": "TANIA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "404-478-9868",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "055194",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "055194",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Alice Nading Mina, M.D.
• Roberto Mina, MD
• Alexandra Minasian
• Jeffrey Hampar Minassian, MD
• Mind Body and Soul Homecare Services
• Mind Body Works LLC
• Mind Restoration, LLC
• Mind, Body, Peace LLC
• Mind'S Eye Enterprises, LLC
• Mindbrain Institute of Atlanta

• Medical Specialty Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Medical Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.