Active NPI
Mindheart Institute and Wellness Center, PLLC
- Psychiatric/Mental Health Nurse Practitioner
- Charlotte, NC
National Provider Identifier
1609598044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- MINDHEART INSTITUTE AND WELLNESS CENTER, PLLC
- Practice address
- 10400 Mallard Creek Rd Ste 208
Charlotte, NC 28262-5207 - Phone
- (704) 351-4221
- NPI assigned
- Sep 13, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Charlene Whitaker-Brown, DNP, MSN, FNP, PMHNP
- Title
- Ceo
- Phone
- (704) 351-4221
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
10400 Mallard Creek Rd Ste 208
Charlotte, NC 28262-5207
Mailing address
PO Box 1302
Harrisburg, NC 28075-1302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
10400 Mallard Creek Rd
Ste 208
Charlotte, NC 28262
Phone (704) 351-4221
325 McGill Ave NW
Ste 505
Concord, NC 28027
Phone (980) 270-1887
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Charlotte, NC
- NPI 1972891836
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1665100800000",
"number": "1609598044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1302",
"city": "HARRISBURG",
"state": "NC",
"postal_code": "280751302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 MALLARD CREEK RD STE 208",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282625207",
"telephone_number": "704-351-4221"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINDHEART INSTITUTE AND WELLNESS CENTER, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-13",
"last_updated": "2022-10-07",
"certification_date": "2022-10-07",
"status": "A",
"authorized_official_last_name": "WHITAKER-BROWN",
"authorized_official_first_name": "CHARLENE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "704-351-4221",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DNP, MSN, FNP, PMHNP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.