NPIMap

Organization Active NPI

Mind, Body, Soul

  • Physical Therapist
  • Eagle River, AK
National Provider Identifier
1780960229
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1653 Issued in AK
Legal business name
MIND, BODY, SOUL
Practice address
12103B Horseshoe Dr
Eagle River, AK 99577-7547
Phone
(907) 696-3657
Fax
(907) 622-3657
NPI assigned
Oct 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Authorized official

Name
Melanie Britt Michaels, PTNPI 1184765448
Title
Owner
Phone
(907) 696-3657

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1653 AK Primary

Addresses

Primary practice location

12103B Horseshoe Dr
Eagle River, AK 99577-7547

Mailing address

PO Box 770502
Eagle River, AK 99577-0502
Phone (907) 696-3657

Other names 1

  • Mind, Body, Soul Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

12103B Horseshoe Dr
Eagle River, AK 99577
Phone (907) 696-3657

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1780960229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770502",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995770502",
            "telephone_number": "907-696-3657",
            "fax_number": "907-622-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12103B HORSESHOE DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777547",
            "telephone_number": "907-696-3657",
            "fax_number": "907-622-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND, BODY, SOUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-28",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "MICHAELS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "BRITT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-696-3657",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind, Body, Soul Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.