Mind Wellness Center

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

MIND WELLNESS CENTER

Practice address

331 E Main St Ste 200
Rock Hill, SC 29730-5384

Phone

(704) 350-5885

Fax

(936) 244-4599

NPI assigned

Apr 9, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Kelly Svedberg, PA-CNPI 1790838621

Title

Owner

Phone

(704) 350-5885

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly G Svedberg, PA-C

  • Physician Assistant
  • Rock Hill, SC
  • NPI 1790838621
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1730708868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7819 JAARS RD",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737677",
            "telephone_number": "704-350-5885",
            "fax_number": "704-843-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E MAIN ST STE 200",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297305384",
            "telephone_number": "704-350-5885",
            "fax_number": "936-244-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "SVEDBERG",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-350-5885",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heyward D Mills
• Jazmyne Mills
• Meredith Mills, LPC
• Mind Body & Soul Behavioral Health and Wellness LLC
• Mind Body Unity LLC (Mind Body Unity Counseling Services)
• Mindful Management LLC
• Mindful Missions of SC (Mindful Missions of SC NonProfit)
• Mindful Missions of SC Inc (Mindful Missions of NC)
• Mindfulness Counseling LLC
• Chabre Mingo, LCAS-A

• Physician Assistant in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.