Active NPI
Mental Restoration Institute
- Psychiatric/Mental Health Nurse Practitioner
- Ruston, LA
National Provider Identifier
1699822296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- MENTAL RESTORATION INSTITUTE
- Practice address
- 300 W Arizona Ave
Ste. B.
Ruston, LA 71270-4306 - Phone
- (318) 251-1233
- Fax
- (318) 254-5023
- NPI assigned
- Jan 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Gloria Denise Mays, N.P.
- Title
- Nurse Practitioner
- Phone
- (318) 251-1233
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | LA | Primary |
Addresses
Primary practice location
300 W Arizona Ave
Ste. B.
Ruston, LA 71270-4306
Mailing address
300 W Arizona Ave
Ste. B.
Ruston, LA 71270-4306
Phone (318) 251-1233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070327000347 | LA | Part B Supplier - Clinic/Group Practice | 6103920442 |
Receives reassigned benefits from 1 practitioner Practice locations: Ruston, LA; Monroe, LA |
National Provider Directory
National Provider DirectoryLocations
1108 Stubbs Ave
Monroe, LA 71201
Phone (318) 251-1233
608 S Trenton St
Ste B
Ruston, LA 71270
Phone (318) 251-1233
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Ruston, LA
- NPI 1194746362
LA, Psychiatric/Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1699822296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W ARIZONA AVE",
"address_2": "STE. B.",
"city": "RUSTON",
"state": "LA",
"postal_code": "712704306",
"telephone_number": "318-251-1233",
"fax_number": "318-254-5023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W ARIZONA AVE",
"address_2": "STE. B.",
"city": "RUSTON",
"state": "LA",
"postal_code": "712704306",
"telephone_number": "318-251-1233",
"fax_number": "318-254-5023"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MENTAL RESTORATION INSTITUTE",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MAYS",
"authorized_official_first_name": "GLORIA",
"authorized_official_middle_name": "DENISE",
"authorized_official_title_or_position": "NURSE PRACTITIONER",
"authorized_official_telephone_number": "318-251-1233",
"authorized_official_name_prefix": "Miss",
"authorized_official_credential": "N.P."
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.