NPIMap

Organization Active NPI

Mindful Performance Center Limited Liability Company

  • Physical Therapy Clinic/Center
  • Columbia, MD
National Provider Identifier
1972074839
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MINDFUL PERFORMANCE CENTER LIMITED LIABILITY COMPANY
Practice address
6570 Dobbin Rd
Columbia, MD 21045-5855
Phone
(443) 538-5758
NPI assigned
Dec 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Authorized official

Name
Jimmy Warren Violand, PTA
Title
Owner
Phone
(443) 538-5758

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Preventive Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2083S0010X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

6570 Dobbin Rd
Columbia, MD 21045-5855

Mailing address

13380 Clarksville Pike Ste I
Highland, MD 20777-9725
Phone (443) 538-5758

Other practice location 1

13380 Clarksville Pike Ste I
Highland, MD 20777-9725
Phone (443) 538-5758

National Provider Directory

National Provider Directory

Locations

13380 Clarksville Pike
Ste I
Highland, MD 20777
Phone (443) 538-5758

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": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1972074839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13380 CLARKSVILLE PIKE STE I",
            "city": "HIGHLAND",
            "state": "MD",
            "postal_code": "207779725",
            "telephone_number": "443-538-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6570 DOBBIN RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455855",
            "telephone_number": "443-538-5758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13380 Clarksville Pike Ste I",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "MD",
            "postal_code": "207779725",
            "country_code": "US",
            "telephone_number": "443-538-5758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL PERFORMANCE CENTER LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "VIOLAND",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-538-5758",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.