MIND BODY MEDICINE INC. (NPI# 1528246295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528246295 |
| Entity Type | Organization |
| Organization Name | MIND BODY MEDICINE INC. |
| Practice Address |
8 N 2nd Ave E Suite 209 Duluth MN 55802-2102 |
| Practice Telephone | 2186282130 |
| Mailing Telephone | 2186282130 |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2008-02-05 |
| Authorized Official Name | DR. GARY G. KOHLS (OWNER) |
| Authorized Official Telephone | 2186282130 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS | 40M27KO | 01 |
| Street Address |
8 N 2ND AVE E SUITE 209 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720071921 | Michele M Gordon | Social Worker | 8 N 2nd Ave E, Duluth, MN 55802-2102 | 2005-08-24 |
| 1215332176 | Leigh Branovan | Social Worker | 8 N 2nd Ave E, Suite 306, Duluth, MN 55802-2102 | 2014-11-04 |
| 1679978530 | Gina Perfetti | Counselor | 8 N 2nd Ave E, Suite 306, Duluth, MN 55802-2102 | 2014-11-04 |
| 1962724963 | Rita V Hughes | Marriage & Family Therapist | 8 N 2nd Ave E, Duluth, MN 55802-2102 | 2010-02-18 |
| 1104006659 | Well-being Counseling and Services Center, LLC | Community/Behavioral Health | 8 N 2nd Ave E, Temple Opera Building, Suite 309, Duluth, MN 55802-2102 | 2007-11-13 |
| 1013125855 | Glen Tobey | Social Worker | 8 N 2nd Ave E, Duluth, MN 55802-2102 | 2007-05-17 |
| 1649393299 | David Wangen | Psychologist | 8 N 2nd Ave E, #206, Duluth, MN 55802-2102 | 2007-04-09 |
| 1992825053 | Marlyn Jean Sternal | Psychologist | 8 N 2nd Ave E, Duluth, MN 55802-2102 | 2007-03-30 |
| 1194849935 | Dustin Holden | Marriage & Family Therapist | 8 N 2nd Ave E, Suite 310, Duluth, MN 55802-2102 | 2007-03-19 |
| 1164563847 | Gary George Kohls | Family Medicine | 8 N 2nd Ave E, Suite 209, Duluth, MN 55802-2102 | 2007-02-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
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| 1275005498 | St. Luke's Hospital of Duluth | Clinic/Center | 1000 E 1st St Ste 204, Duluth, MN 55805-2297 | 2018-12-28 |
| 1730657271 | Vitality Ageless Center LLC | Clinic/Center | 1611 Satellite Blvd Ste 3, Duluth, GA 30097-4913 | 2018-11-02 |
| 1588147839 | Ideal Option, Pllc | Clinic/Center | 831 E 2nd St, Duluth, MN 55805-2103 | 2018-09-12 |
| 1184168205 | Brown Optical | Clinic/Center | 3751 Satellite Blvd, #200, Duluth, GA 30096-8840 | 2016-12-08 |
| 1932658051 | Vaned Health LLC | Clinic/Center | 6340 Sugarloaf Pkwy Ste 200, Duluth, GA 30097-4329 | 2016-09-30 |
| 1912366931 | River Parc Internal Medicine | Clinic/Center | 4855 River Green Pkwy Ste 140, Duluth, GA 30096-8333 | 2016-02-18 |
| 1588960835 | Peachtree Chiropractic Center | Clinic/Center | 3294 Peachtree Industrial Blvd, Suite 2005, Duluth, GA 30096-8322 | 2011-02-03 |
| 1710280656 | New Gyn LLC | Clinic/Center | 3840 Peachtree Industrial Blvd, 275, Duluth, GA 30096-5031 | 2010-12-15 |
| 1063726743 | St. Luke's Hospital | Clinic/Center | 915 E 1st St, Duluth, MN 55805-2107 | 2010-08-05 |
| Find all providers in DULUTH | ||||
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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.