Mindy Jo Roberts Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MINDY JO ROBERTS INC

Practice address

2600 Dodge St Ste D4
Dubuque, IA 52003-7161

Phone

(563) 590-6597

NPI assigned

Feb 28, 2020

Organization subpart

No

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

Authorized official

Name

Mindy Jo Roberts, ARNPNPI 1447680848

Title

President

Phone

(563) 590-6597

Specialties & licenses 1

Addresses

Other names 1

• A Mindful Journey Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Practitioners 1

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

• Mindy Jo Roberts, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dubuque, IA
  • NPI 1447680848

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1760016786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15740 N CASCADE RD",
            "city": "PEOSTA",
            "state": "IA",
            "postal_code": "520687027",
            "telephone_number": "563-590-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 DODGE ST STE D4",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037161",
            "telephone_number": "563-590-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDY JO ROBERTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-590-6597",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mindy_roberts@clarke.edu",
            "affiliation": "N",
            "address_1": "2600 Dodge St Ste D4",
            "city": "Dubuque",
            "state": "IA",
            "country_code": "US",
            "postal_code": "520037161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "A Mindful Journey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.