Organization Active NPI

Mindful Growth LLC

  • Primary Care Clinic/Center
  • Anchorage, AK
National Provider Identifier
1609592716
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MINDFUL GROWTH LLC
Practice address
4141 B St Ste 308
Anchorage, AK 99503-5942
Phone
(907) 229-0622
NPI assigned
Oct 19, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Susan Beesley, MDNPI 1427198381
Title
Owner
Phone
(907) 229-0622

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

Practitioners 1

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

National Provider Directory

National Provider Directory

Locations

4141 B St
Ste 308
Anchorage, AK 99503
Phone (907) 229-0622

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

NPPES NPI Registry

Primary practice location

4141 B St Ste 308
Anchorage, AK 99503-5942

Mailing address

4825 Queens CT
Anchorage, AK 99508-4812
Phone (907) 229-0622

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1009668MedicaidAK

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 19, 2022.

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1609592716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 QUEENS CT",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084812",
            "telephone_number": "907-229-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 B ST STE 308",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035942",
            "telephone_number": "907-229-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL GROWTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "BEESLEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-229-0622",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009668",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.