Individual provider Active NPI

Mark Wesbrock, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1003293606
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP7776 Issued in AZ
Practice address
4001 E Baseline Rd Ste 204
Gilbert, AZ 85234-2743
Phone
(480) 565-6440
Fax
(480) 452-0691
NPI assigned
May 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X AP7776 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP7776 AZ Primary

Addresses

Primary practice location

4001 E Baseline Rd Ste 204
Gilbert, AZ 85234-2743

Mailing address

4001 E Baseline Rd Ste 204
Gilbert, AZ 85234-2743
Phone (480) 269-2971

Other practice location 1

15300 N 90th St Ste 750
Scottsdale, AZ 85260-2776
Phone (480) 565-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171103000288 AZ Practitioner - Nurse Practitioner 5092071282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lighthouse Psychiatry LLCGroup PAC ID 0547545824, 5 clinicians

Practice addresses (Care Compare)

4001 E Baseline Rd
Suite 204
Gilbert, AZ 85234-2743
Phone (480) 565-6440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Psychiatry LLC Psychiatric/Mental Health CurrentSince Sep 26, 2025 Accepting new patients
Lifewell Behavioral Wellness Past Accepting new patients
Open Mind Group LLC Past Accepting new patients
Oakwood Creative Care Inc. PastSince Mar 12, 2024 Accepting new patients

Locations

4001 E Baseline Rd
Ste 204
Gilbert, AZ 85234
Phone (480) 269-2971

15300 N 90th St
Ste 750
Scottsdale, AZ 85260
Phone (480) 269-2971

Interoperability endpoints

  • Direct secure messaging: mark.wesbrocknp.p1@direct.lifewell.nextgenshare.com
  • Direct secure messaging: mark.wesbrock.1@32088.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/16935/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1003293606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 204",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342743",
            "telephone_number": "480-269-2971",
            "fax_number": "480-452-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 204",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342743",
            "telephone_number": "480-565-6440",
            "fax_number": "480-452-0691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15300 N 90th St Ste 750",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852602776",
            "country_code": "US",
            "telephone_number": "480-565-6440",
            "fax_number": "480-452-0691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESBROCK",
        "first_name": "MARK",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-03",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP7776",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP7776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.