Mind Body Medicine Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MIND BODY MEDICINE INC.

Practice address

8 N 2ND Ave E
Suite 209
Duluth, MN 55802-2102

Phone

(218) 628-2130

NPI assigned

Feb 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gary G. Kohls, M.D.

Title

Owner

Phone

(218) 628-2130

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1528246295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 N 2ND AVE E",
            "address_2": "SUITE 209",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022102",
            "telephone_number": "218-628-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 N 2ND AVE E",
            "address_2": "SUITE 209",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022102",
            "telephone_number": "218-628-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY MEDICINE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "KOHLS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-628-2130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "40M27KO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Miller, DNP
• Roger Kevin Miller, MD
• Randall E. Millikan, MD, PHD
• Heather Rene Millis, PA-C
• Katherine R Mills, RN, CRNA
• Martha Mindak
• Mindful Beginnings Counseling
• Bobby Jo Mineheine, CCC/SLP
• Jeanna Miner, OTR
• Mary Catherine Minke, DO

• Clinic/Center in Duluth, MN
• Providers in Duluth, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.