Individual provider Active NPI

Patrishia Bogan, PMHNP

  • Health & Wellness Coach
  • Peoria, AZ
National Provider Identifier
1003683350
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
RN207963 Issued in AZ
Practice address
9250 W Lone Cactus Dr
Peoria, AZ 85382-8329
Phone
(480) 702-8222
NPI assigned
Dec 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X RN207963 AZ Primary

Addresses

Primary practice location

9250 W Lone Cactus Dr
Peoria, AZ 85382-8329

Mailing address

29520 N 113TH LN
Peoria, AZ 85383-4569
Phone (480) 828-8551

Other names 1

  • Patrishia Elyzze Bogan Other name

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
I20260302000451 AZ Order and Referring Only - Nurse Practitioner 8123500089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN207963AZMDHealth & Wellness Coach

Practice roles

OrganizationSpecialtyStatusNew patients
Resilient Solutions Counseling and Consulting Services LLC CurrentSince Dec 10, 2023 Accepting new patients

Organizations & group practices 1

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": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1003683350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29520 N 113TH LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853834569",
            "telephone_number": "480-828-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 W LONE CACTUS DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828329",
            "telephone_number": "480-702-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "PATRISHIA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "AZ",
            "license": "RN207963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRISHIA",
            "last_name": "BOGAN",
            "middle_name": "ELYZZE",
            "credential": "PMHNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.