Growth Mindset Wellness PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

GROWTH MINDSET WELLNESS PC

Practice address

175 Corporate Center Dr Ste B
Stockbridge, GA 30281-7382

Phone

(470) 275-2358

NPI assigned

Jul 4, 2022

Last updated

Feb 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tiffany Bates, APRNNPI 1457943813

Title

Owner

Phone

(470) 275-2358

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

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.

• Tiffany Tamaira Bates, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Stockbridge, GA
  • NPI 1457943813
  Medicare reassignment Care Compare group NPD Authorized official
• Whitney Robinson, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Stockbridge, GA
  • NPI 1205528403
  Medicare reassignment Care Compare group NPD
• Avis Gibson Holmes, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
  • NPI 1861257149
  Medicare reassignment NPD

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

{
    "created_epoch": "1656892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1699408005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CORPORATE CENTER DR STE B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817382",
            "telephone_number": "470-275-2358",
            "fax_number": "470-319-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CORPORATE CENTER DR STE B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817382",
            "telephone_number": "470-275-2358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Belvedere Rd Ste H",
            "address_purpose": "LOCATION",
            "city": "Haverhill",
            "state": "FL",
            "postal_code": "334151357",
            "country_code": "US",
            "telephone_number": "561-220-8579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GROWTH MINDSET WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-04",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-275-2358",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanice Shardae Griffin
• Tameeshia Rashon Griffin
• Kathleen Elizabeth Grimes, PH.D.
• Alice Gross, RNFA
• Lawrence R. Gross, M.D.
• Tanaya Guerra
• Brij B Gulati, MD
• Kevin Gunderson, DO
• David Sahid Gunn, P.T.
• Tarsem L Gupta, MD

• Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.