Active NPI
Mindset Wellness Center
- Psychiatric/Mental Health Nurse Practitioner
- College Park, MD
National Provider Identifier
1972330447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- MINDSET WELLNESS CENTER
- Practice address
- 4920 Niagara Rd Ste 102
College Park, MD 20740-1103 - Phone
- (301) 241-6000
- Fax
- (301) 747-7400
- NPI assigned
- Sep 18, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Olubunmi Salami
- Title
- Ceo
- Phone
- (301) 241-6000
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
4920 Niagara Rd Ste 102
College Park, MD 20740-1103
Mailing address
4920 Niagara Rd Ste 102
College Park, MD 20740-1103
Phone (301) 241-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Mindset Wellness Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatric/Mental Health Nurse Practitioner
- College Park, MD
- NPI 1245054329
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": "1726617600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727827200000",
"number": "1972330447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 NIAGARA RD STE 102",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207401103",
"telephone_number": "301-241-6000",
"fax_number": "301-747-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4920 NIAGARA RD STE 102",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207401103",
"telephone_number": "301-241-6000",
"fax_number": "301-747-7400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINDSET WELLNESS CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2024-09-18",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A",
"authorized_official_last_name": "SALAMI",
"authorized_official_first_name": "OLUBUNMI",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "301-241-6000",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.