Pottsville Peace of Mind LLC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

Legal business name

POTTSVILLE PEACE OF MIND LLC

Practice address

21 S Centre St
Pottsville, PA 17901-3014

Phone

(272) 224-1604

Fax

(570) 628-5298

NPI assigned

Jan 30, 2019

Organization subpart

No

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

Authorized official

Name

Teresa BlattNPI 1598982266

Title

RN/Owner

Phone

(272) 224-1604

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

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

• Teresa Ann Blatt, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Pottsville, PA
  • NPI 1598982266
  Medicare reassignment NPD Authorized official
• Mandie Lynn Burgess Gonzalez, LSW

  • Social Worker
  • Pottsville, PA
  • NPI 1568614394
  NPD (past)

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1770047151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1244",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179017244",
            "telephone_number": "272-224-1604",
            "fax_number": "570-628-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 S CENTRE ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013014",
            "telephone_number": "272-224-1604",
            "fax_number": "570-628-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSVILLE PEACE OF MIND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "BLATT",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "RN/OWNER",
        "authorized_official_telephone_number": "272-224-1604"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pottsville Internists Associates Inc
• Pottsville Internists Associates, Inc
• Pottsville Medical Services, LLC
• Pottsville Operations LLC
• Pottsville Oral Surgery, PC
• Pottsville Pediatric Dental Center
• Pottsville Radiology Associates
• Pottsville Rehabilitation LLC
• Pottsville Sleep Physicians LLC
• Pottsville SNF Operations LLC

• Psychiatric/Mental Health Registered Nurse in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Psychiatric/Mental Health Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.