HEALTHY MIND FIT BODY (NPI# 1932757937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932757937 |
| Entity Type | Organization |
| Organization Name | HEALTHY MIND FIT BODY |
| Practice Address |
7901 S 12th St Ste 201 Portage MI 49024-3831 |
| Practice Telephone | 2695980587 |
| Mailing Telephone | 2695980587 |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-03 |
| Authorized Official Name | GARRETT BROOKMYER (OWNER) |
| Authorized Official Telephone | 2695980587 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
7901 S 12TH ST STE 201 |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-3831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912209156 | Shamika Hall | Psychologist | 7901 S 12th St Ste 201, Portage, MI 49024-3831 | 2010-11-19 |
| 1407217961 | Valerie Fedewa | Chiropractor | 7901 S 12th St Ste 201, Portage, MI 49024-3831 | 2016-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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| 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.