Organization Active NPI

Your Mentality, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1528759255
Registry record updated Nov 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
YOUR MENTALITY, LLC
Practice address
100 S Ashley Dr Ste 600
Tampa, FL 33602-5300
Phone
(866) 786-2502
Fax
(866) 786-2502
NPI assigned
May 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2023

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

Authorized official

Name
Ann Marie Brown, APRNNPI 1124751300
Title
Ceo
Phone
(866) 786-2502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

100 S Ashley Dr Ste 600
Tampa, FL 33602-5300

Mailing address

129 Sophia CT
Napa, CA 94558-5947
Phone (732) 261-0992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240318001942 CA Part B Supplier - Clinic/Group Practice 9739526476 Receives reassigned benefits from 1 practitioner
Practice locations: Napa, CA

National Provider Directory

National Provider Directory

Locations

1300 1st St
Ste 368
Napa, CA 94559
Phone (408) 610-2040

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699142400000",
    "number": "1528759255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 SOPHIA CT",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945585947",
            "telephone_number": "732-261-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ASHLEY DR STE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025300",
            "telephone_number": "866-786-2502",
            "fax_number": "866-786-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR MENTALITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-11-05",
        "certification_date": "2023-11-05",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ANN MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-786-2502",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.