NPIMap

Organization Active NPI

Mindwell LLC

  • Anesthesiology Physician
  • Greenville, SC
National Provider Identifier
1699491852
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MINDWELL LLC
Practice address
16 Mills Ave Ste 6
Greenville, SC 29605-4065
Phone
(864) 735-8080
NPI assigned
Oct 18, 2022
Last updated
Jun 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Dr. Jarod Motley, MDNPI 1578644704
Title
Founder/ Ceo
Phone
(864) 735-8080

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)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary
Clinic/Center 261Q00000X NU

Addresses

Primary practice location

16 Mills Ave Ste 6
Greenville, SC 29605-4065

Mailing address

16 Mills Ave Ste 6
Greenville, SC 29605-4065

Other practice location 1

4126 Clemson Blvd Ste 2C
Anderson, SC 29621-1113
Phone (864) 735-8080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221220001345 SC Part B Supplier - Clinic/Group Practice 9931578606 Receives reassigned benefits from 12 practitioners
Practice locations: Anderson, SC; Greenville, SC

National Provider Directory

National Provider Directory

Locations

4126 Clemson Blvd
Ste 2C
Anderson, SC 29621
Phone (678) 372-0985

Practitioners & affiliated clinicians

Practitioners 12

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": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1699491852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MILLS AVE STE 6",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MILLS AVE STE 6",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054065",
            "telephone_number": "864-735-8080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4126 Clemson Blvd Ste 2C",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296211113",
            "country_code": "US",
            "telephone_number": "864-735-8080",
            "fax_number": "800-889-1826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDWELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "MOTLEY",
        "authorized_official_first_name": "JAROD",
        "authorized_official_title_or_position": "FOUNDER/ CEO",
        "authorized_official_telephone_number": "864-735-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.