NPIMap

Organization Active NPI

Mind Over Matter LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Opp, AL
National Provider Identifier
1700402955
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MIND OVER MATTER LLC
Practice address
131 E Covington Ave
Opp, AL 36467-2122
Phone
(334) 456-0300
Fax
(716) 265-3348
NPI assigned
Jun 23, 2020
Last updated
Aug 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Mr. David Russell Adams, CRNPNPI 1275158578
Title
CRNP/ Owner
Phone
(334) 456-0300

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

131 E Covington Ave
Opp, AL 36467-2122

Mailing address

29289 Beulah Church Rd
Opp, AL 36467-4307
Phone (334) 456-0300

Other practice location 1

218 Hospital Ave Ste D
Ozark, AL 36360-2072
Phone (334) 456-0300

Other practice location 2

702 N Main St
Opp, AL 36467-1626
Phone (334) 456-0300

National Provider Directory

National Provider Directory

Locations

131 E Covington Ave
Opp, AL 36467
Phone (334) 456-0300

511 Brantley St
Opp, AL 36467
Phone (334) 493-3240

Practitioners & affiliated clinicians

Practitioners 5

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": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1700402955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29289 BEULAH CHURCH RD",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364674307",
            "telephone_number": "334-456-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 E COVINGTON AVE",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364672122",
            "telephone_number": "334-456-0300",
            "fax_number": "716-265-3348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "218 Hospital Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Ozark",
            "state": "AL",
            "postal_code": "363602072",
            "country_code": "US",
            "telephone_number": "334-456-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 N Main St",
            "address_purpose": "LOCATION",
            "city": "Opp",
            "state": "AL",
            "postal_code": "364671626",
            "country_code": "US",
            "telephone_number": "334-456-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND OVER MATTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "CRNP/ OWNER",
        "authorized_official_telephone_number": "334-456-0300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opp, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.