NPIMap

Organization Active NPI

Mindfulness Based Interventions LLC

  • Adult Mental Health Clinic/Center
  • Ridgway, CO
National Provider Identifier
1679067490
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MINDFULNESS BASED INTERVENTIONS LLC
Practice address
380 Sherman St
Ridgway, CO 81432
Phone
(970) 318-0529
Fax
(855) 403-3931
NPI assigned
Jun 15, 2018
Last updated
Feb 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Nichole L Moorman, LCSWNPI 1053554964
Title
Owner
Phone
(970) 318-0529

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

380 Sherman St
Ridgway, CO 81432

Mailing address

PO Box 12
Ouray, CO 81427-0012
Phone (970) 318-0529

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180130000321 CO Part B Supplier - Clinic/Group Practice 2961762547 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Montrose, CO; Ridgway, CO

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1679067490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "OURAY",
            "state": "CO",
            "postal_code": "814270012",
            "telephone_number": "970-318-0529",
            "fax_number": "855-403-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 SHERMAN ST",
            "city": "RIDGWAY",
            "state": "CO",
            "postal_code": "81432",
            "telephone_number": "970-318-0529",
            "fax_number": "855-403-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULNESS BASED INTERVENTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "MOORMAN",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-318-0529",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgway, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.

Verify at the official NPI Registry.