Mind & Body Healthcare LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MIND & BODY HEALTHCARE LLC

Practice address

1700 N Union Ave
Roswell, NM 88201-3267

Phone

(575) 489-4750

Fax

(575) 586-4414

NPI assigned

Dec 31, 2019

Organization subpart

No

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

Authorized official

Name

Jon E Perry, PANPI 1740376102

Title

Owner

Phone

(575) 489-4750

Specialties & licenses 6

Addresses

Other names 1

• Jon Perry MPAS C-PA Doing business as

Practitioners 1

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

• Jon E Perry, PA

  • Physician Assistant
  • Roswell, NM
  • NPI 1740376102
  NPD Authorized official

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1770122277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 GARDEN PL",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882017767",
            "telephone_number": "575-489-4750",
            "fax_number": "575-586-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N UNION AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013267",
            "telephone_number": "575-489-4750",
            "fax_number": "575-586-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND & BODY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-31",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-489-4750",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jon Perry MPAS C-PA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jon Perry MPAS C-PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kendall Leeann Miller
• Kristen Diamond Miller
• Roland Wesley Miller, BC-HIS, ACA
• Shawna Miller
• Trevor Miller, DO
• Rosa Miranda
• Ankita Mishra, MD
• Mission Arch Operator LLC
• Saneal Mistry, DDS
• Michael J. Mitchell, M.D.

• Clinic/Center in Roswell, NM
• Providers in Roswell, NM by specialty
• Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.