Organization Active NPI

A Good Mind Too

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, MS
National Provider Identifier
1841933272
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
A GOOD MIND TOO
Practice address
1012 E Main St
Philadelphia, MS 39350-2308
Phone
(601) 416-0068
NPI assigned
Apr 14, 2022
Last updated
Nov 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Authorized official

Name
Adriana Jenkins, APRNNPI 1255988580
Title
Pmhnp-BC
Phone
(601) 389-7889

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
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1012 E Main St
Philadelphia, MS 39350-2308

Mailing address

1012 E Main St
Philadelphia, MS 39350-2308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220621001132 MS Part B Supplier - Clinic/Group Practice 2062891161 Receives reassigned benefits from 3 practitioners
Practice locations: Philadelphia, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2259718A Good Mind Too1012 East Main St, Philadelphia, MS 39350Certificate of waiverMay 9, 2028

National Provider Directory

National Provider Directory

Locations

1012 E Main St
Philadelphia, MS 39350
Phone (601) 389-7889

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1841933272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 E MAIN ST",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E MAIN ST",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502308",
            "telephone_number": "601-416-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A GOOD MIND TOO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "601-389-7889",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.