EXTRAORDINARY MINDS
NPI 1538856398
Nurse Practitioner - Psychiatric/Mental Health in Evesham, NJ

Q: What is Extraordinary Minds's NPI number?

The NPI number for Extraordinary Minds is 1538856398. It was assigned to this organization in the NPPES registry on April 21, 2023.

Q: What is Extraordinary Minds's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since April 21, 2023

532 OLD MARLTON PIKE W, SUITE 510, EVESHAM, NJ 08053(856) 242-2121(856) 242-2121 Get Directions Write a Review

NPPES record last updated: April 21, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Extraordinary Minds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXTRAORDINARY MINDS (NPI 1538856398) is a healthcare organization registered as a psychiatric/mental health in Evesham, New Jersey and active in the NPI registry since April 2023. The organization lists Karen Wallace, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1538856398

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameEXTRAORDINARY MINDS

Location Address532 OLD MARLTON PIKE W, SUITE 510Evesham, NJ 08053

Mailing Address15 Roberts Way SeAcworth, GA 30102-6873 · (470) 446-5360

Phone(856) 242-2121

Fax(856) 242-2121

Organization SubpartNo

Authorized OfficialKaren WallaceCredentialing · (470) 446-5360

Enumeration DateApril 21, 2023

NPPES CertifiedApril 14, 2023

✔ NPI 1538856398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

532 OLD MARLTON PIKE W, Evesham, NJ 08053

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALEX TERRY MAKRIS MD

Internal Medicine (Infectious Disease)

532 OLD MARLTON PIKE W, PMB #195
MARLTON, NJ 08053

Burlington County (856) 424-0600

ALEXSANDRIA WILLIAMS LCSW

Social Worker (Clinical)

532 OLD MARLTON PIKE W, #554
MARLTON, NJ 08053

Burlington County (856) 426-5491

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Extraordinary Minds's NPI number?

The NPI number for Extraordinary Minds is 1538856398. It was assigned to this organization in the NPPES registry on April 21, 2023.

Where is Extraordinary Minds located?

Extraordinary Minds is located at 532 Old Marlton Pike W Suite 510, Evesham, NJ 08053. The listed phone number is (856) 242-2121.

What is Extraordinary Minds's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Extraordinary Minds was last updated on April 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.