Organization Active NPI

Kaizen Mind Performance Solutions

  • Exercise & Sports Psychologist
  • San Antonio, TX
National Provider Identifier
1912731688
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exercise & Sports PsychologistTaxonomy code 103TE1100X
Legal business name
KAIZEN MIND PERFORMANCE SOLUTIONS
Doing business as
Kaizen Mind Performance Solutions
Practice address
7022 Knights HVN
San Antonio, TX 78233-3823
Phone
(830) 356-6687
NPI assigned
Aug 27, 2024
Last updated
Aug 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Carla Davis Gray
Title
Ceo
Phone
(218) 800-1969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exercise & Sports PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TE1100X Primary

Addresses

Primary practice location

7022 Knights HVN
San Antonio, TX 78233-3823

Mailing address

7022 Knights HVN
San Antonio, TX 78233-3823
Phone (830) 356-6687

Other names 1

  • Kaizen Mind Performance Solutions Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1912731688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7022 KNIGHTS HVN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782333823",
            "telephone_number": "830-356-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7022 KNIGHTS HVN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782333823",
            "telephone_number": "830-356-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIZEN MIND PERFORMANCE SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS GRAY",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-800-1969"
    },
    "taxonomies": [
        {
            "code": "103TE1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Exercise & Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaizen Mind Performance Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.