Mind Body Nourish LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

MIND BODY NOURISH LLC

Practice address

2625 W Girard Ave
Philadelphia, PA 19130-1333

Phone

(305) 930-2967

NPI assigned

Jan 9, 2025

Organization subpart

No

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

Authorized official

Name

Mrs. Anisa Ortiz, CRNPNPI 1427642537

Title

Owner

Phone

(305) 930-2967

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Anisa J Ortiz, NP

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
  • NPI 1427642537

  Adult Health

  NPD Authorized official

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1740090026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 MEREDITH PL",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202258",
            "telephone_number": "267-455-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301333",
            "telephone_number": "305-930-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY NOURISH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "ANISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-930-2967",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Andrew Minarcik, D.O
• Minard Duka DMD PC
• Alexis Brooke Mincer, PA-C
• Bohdan M Minczak, MD
• Mind Belly Soul Nutrition LLC
• Mind Power Counseling LLC
• Jodi Mindell, PH.D.
• Mindful Essence Therapeutic Services, LLC
• Mindful Health Center LLC
• Mindful Pathway LLC

• Adult Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.