MIND AND BODY WELLNESS CLINIC – NPI #1063048668
Psychiatry & Neurology

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Health Care Provider Taxonomy Code for Psychiatry & Neurology

MIND AND BODY WELLNESS CLINIC is a psychiatry & neurologist located in CORDOVA, TN. NPPES has assigned the NPI number 1063048668 to MIND AND BODY WELLNESS CLINIC on March 16, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2084P0804X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MIND AND BODY WELLNESS CLINIC below.

NPI Profile for
MIND AND BODY WELLNESS CLINIC

NPI Number
1063048668
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MIND AND BODY WELLNESS CLINIC
Primary location
1176 VICKERY LN STE 100
CORDOVA, TN 38016-0631
Phone: (901) 737-1992 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
TONYA MALADY
CREDENTIALING
Phone: (901) 737-1992
Updated
Certification Date
Mar 16, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MIND AND BODY WELLNESS CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERLICENSETN44725
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2084P0804X
- Psychiatry & Neurology / Child & Adolescent Psychiatry (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
EHR
Endpoint type
SOAP URL
Endpoint Description
EHR
Content Type
CSV
Affiliation
N
Endpoint Location
1176 VICKERY LN STE 100,
CORDOVA, TN 77025-1669