Organization Active NPI

Mental Restoration Institute

  • Psychiatric/Mental Health Nurse Practitioner
  • Ruston, LA
National Provider Identifier
1699822296
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
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

Updated by the provider on Aug 22, 2020

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.NPI 1194746362
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)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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 Directory

Locations

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.

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.

Verify at the official NPI Registry.