Restorative Minds, PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

RESTORATIVE MINDS, PLLC

Practice address

416 McCullough Dr Ste 205
Charlotte, NC 28262-4392

Phone

(704) 912-1725

NPI assigned

Nov 8, 2021

Organization subpart

No

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

Authorized official

Name

Tiffanie Adams, PANPI 1457600033

Title

Owner

Phone

(704) 606-2220

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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

• Tiffanie Lauren Adams, PA-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1457600033
  NPD Authorized official

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1821753476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 MCCULLOUGH DR STE 205",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 MCCULLOUGH DR STE 205",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624392",
            "telephone_number": "704-912-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE MINDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TIFFANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-606-2220",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "proficientconsultingservices@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "416 McCullough Dr Ste 205",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282624392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.