Organization Active NPI

Mindful Living LLC

  • Occupational Therapist
  • Sioux City, IA
National Provider Identifier
1912520404
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
MINDFUL LIVING LLC
Practice address
5114 Bushnell Ave
Sioux City, IA 51106-3737
Phone
(605) 691-5093
NPI assigned
May 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Mrs. Robyn MellangNPI 1891184255
Title
Owner
Phone
(605) 691-5093

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
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

5114 Bushnell Ave
Sioux City, IA 51106-3737

Mailing address

5114 Bushnell Ave
Sioux City, IA 51106-3737
Phone (605) 691-5093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201106002009 SD Part B Supplier - Clinic/Group Practice 0446660179 Receives reassigned benefits from 1 practitioner
Practice locations: Brookings, SD
O20201123001390 IA Part B Supplier - Clinic/Group Practice 0446660179 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1589846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1912520404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 BUSHNELL AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063737",
            "telephone_number": "605-691-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 BUSHNELL AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063737",
            "telephone_number": "605-691-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "MELLANG",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-691-5093",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.