Mint Edition Wellness Center

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

MINT EDITION WELLNESS CENTER

Practice address

1400 N Mount Juliet Rd Ste 104
Mount Juliet, TN 37122-1508

Phone

(870) 335-6990

NPI assigned

Jul 28, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Long

Title

Director

Phone

(870) 335-6990

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1669081477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N MOUNT JULIET RD STE 104",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371221508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N MOUNT JULIET RD STE 104",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371221508",
            "telephone_number": "870-335-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT EDITION WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "870-335-6990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brandi Miller, OT
• Tierra Miller
• Tenajah A Mills
• Minding Your Helath, Inc.
• Alicia D Mitchell, PHARMD
• Ashley Mitchell, DC
• Kathryn Shetley Mitchell
• Kevin Jay Mitchell, D.C.
• Mica Erin Carter Mitchell, SLP

• Health Service Clinic/Center in Mount Juliet, TN
• Providers in Mount Juliet, TN by specialty
• Health Service Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.