MINDFUL SPORT AND PERFORMANCE (NPI# 1508470428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508470428 |
| Entity Type | Organization |
| Organization Name | MINDFUL SPORT AND PERFORMANCE |
| Practice Address |
401 S Main St Alpharetta GA 30009-1974 |
| Practice Telephone | 4047838135 |
| Mailing Telephone | 4047838135 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | SHENA F LOCKE (CEO) |
| Authorized Official Telephone | 4047838135 |
| Authorized Official Credential | LAPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1800X |
Clinic/Center Specialization: Corporate Health |
Ambulatory Health Care Facilities | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 305R00000X | Preferred Provider Organization | Managed Care Organizations | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
401 S MAIN ST |
| City | ALPHARETTA |
| State | GA |
| Zip Code | 30009-1974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457724874 | Eunice Momeh | Nurse Practitioner | 401 S Main St, Alpharetta, GA 30009-1974 | 2015-11-06 |
| 1225448178 | Neil D Patel | Internal Medicine | 401 S Main St, Suite A4, Alpharetta, GA 30009-1974 | 2014-04-30 |
| 1437576659 | Spectrum Internal Medicine, LLC | Clinic/Center | 401 S Main St, Suite B3, Alpharetta, GA 30009-1974 | 2014-03-26 |
| 1982941456 | Beverly Jean Tanner | Advanced Practice Midwife | 401 S Main St, Suite B-8, Alpharetta, GA 30009-1974 | 2013-01-03 |
| 1457601312 | Alpharetta Podiatry | Podiatrist | 401 S Main St, Unit A-1, Alpharetta, GA 30009-1974 | 2012-09-18 |
| 1689820748 | Omar Naoulo | Podiatrist | 401 S Main St, Unit A-1, Alpharetta, GA 30009-1974 | 2008-08-08 |
| 1841455094 | Ashish N Kakadia | Dentist | 401 S Main St, Suite B5, Alpharetta, GA 30009-1974 | 2008-07-26 |
| 1396911319 | Kathryn G Botelho | Advanced Practice Midwife | 401 S Main St, Suite B-8, Alpharetta, GA 30004-1974 | 2008-04-30 |
| 1295907863 | Alpharetta Highway Dental Group | Dentist | 401 S Main St, Alpharetta, GA 30004-1974 | 2008-03-24 |
| 1619155306 | Main Street Internal Medicine & Pediatrics PC | Internal Medicine | 401 S Main St, Suite C5, Alpharetta, GA 30009-7960 | 2008-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861017634 | Trinity Care Counseling | Community/Behavioral Health | 3475 Northwinds Parkway, 200, Alpharetta, GA 30009 | 2020-06-08 |
| 1437778354 | Therapeutic Alliance LLC | Social Worker | 2300 Lakeview Parkway, Suite 700, Alpharetta, GA 30009 | 2020-04-10 |
| 1457901209 | Carehere LLC | Family Medicine | Carehere Clinic- Jackson Healthcare, 2655 Northwinds Pkwy, Alpharetta, GA 30009 | 2019-09-13 |
| 1952888927 | Total Access Pediatrics LLC | Pediatrics | 401 S Main St Ste A1, Alpharetta, GA 30009 | 2018-07-23 |
| 1356836878 | Hcenti, LLC | Audiologist-Hearing Aid Fitter | 2365 Old Milton Parkway, Alpharetta, GA 30009 | 2018-06-27 |
| 1093203341 | Samantha Elizabeth Heuwagen | Marriage & Family Therapist | 286 S Main St Ste 100, Alpharetta, GA 30009 | 2018-04-23 |
| 1275035578 | Personal Concierge Md, LLC | Internal Medicine | 10105 Westside Parkway, Suite 110, Alpharetta, GA 30009 | 2018-03-02 |
| 1124474929 | Allyne Anesthesia PC | Anesthesiology | 11675 Rainwater Drive, Suite 250, Alpharetta, GA 30009 | 2016-05-11 |
| 1932579885 | Patricia Aycock Jones Garrett | Nurse Practitioner | 1031a Cambridge Square, Alpharetta, GA 30009 | 2015-10-05 |
| 1558770123 | Terry A Williams | Physician Assistant | 2400 Old Milton Parkway, #1433, Alpharetta, GA 30009 | 2014-08-07 |
| Find all providers in zip 30009 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499987 | Conard Peacock | Counselor | 9065 Brockham Way, Alpharetta, GA 30022-8505 | 2020-05-21 |
| 1083249148 | Amanda Faye Ray | Counselor | 11675 Century Dr Ste B&c, Alpharetta, GA 30009-8366 | 2020-03-10 |
| 1689210916 | Shannon Mercer Pugh | Counselor | 5755 N Point Pkwy Ste 240, Alpharetta, GA 30022-1173 | 2019-11-21 |
| 1225687775 | Claire Smith Parker | Counselor | 11807 Northfall Ln Ste 902, Alpharetta, GA 30009-7972 | 2019-09-07 |
| 1235601626 | Faith and Hope Counseling Services LLC | Counselor | 286 S Main St Ste 400, Alpharetta, GA 30009-1943 | 2018-12-22 |
| 1427543032 | Neal Baker | Counselor | 5755 N Point Pkwy Ste 90, Alpharetta, GA 30022 | 2018-06-26 |
| 1689184210 | Ruth Santos-ortiz | Counselor | 1065 Powers Pl Ste B, Alpharetta, GA 30009-7205 | 2017-10-10 |
| 1447779095 | Tameka Michelle Scott | Counselor | 426 Deerfield Pt, Alpharetta, GA 30004-8933 | 2017-09-14 |
| 1235582669 | Meschelle King | Counselor | 4575 Webb Bridge Rd, 2382, Alpharetta, GA 30005-4256 | 2016-07-20 |
| 1346698594 | Jai Dames | Counselor | 5575 North Point Pkwy, Suite 205, Alpharetta, GA 30022-3720 | 2016-05-27 |
| Find all providers in ALPHARETTA | ||||
| City | ALPHARETTA |
| Zip Code | 30009 |
Please comment or provide details below to improve the information on MINDFUL SPORT AND PERFORMANCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.