NPIMap

Organization Active NPI

Mind Body Works Telehealth LLC

  • Nurse Practitioner
  • Hazelwood, MO
National Provider Identifier
1699412254
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MIND BODY WORKS TELEHEALTH LLC
Practice address
8701 Santa Bella Dr
Hazelwood, MO 63042-2917
Phone
(314) 330-6959
NPI assigned
May 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Authorized official

Name
Olivia Young, NPNPI 1891993028
Title
Owner/Operator
Phone
(314) 330-6959

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

8701 Santa Bella Dr
Hazelwood, MO 63042-2917

Mailing address

8701 Santa Bella Dr
Hazelwood, MO 63042-2917
Phone (314) 330-6959

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.

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1699412254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 SANTA BELLA DR",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630422917",
            "telephone_number": "314-330-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 SANTA BELLA DR",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630422917",
            "telephone_number": "314-330-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY WORKS TELEHEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "314-330-6959",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazelwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.