NPIMap

Organization Active NPI

Mile High Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Calabasas, CA
National Provider Identifier
1013655737
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MILE HIGH PSYCHIATRY LLC
Practice address
4500 Park Granada Ste 202
Calabasas, CA 91302-1666
Phone
(720) 507-4779
Fax
(720) 367-5067
NPI assigned
May 23, 2022
Organization subpart
Yes
Parent organization
MILE HIGH PSYCHIATRY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Authorized official

Name
Michael K Chism II, PMHNP-BCNPI 1154780757
Title
Ceo
Phone
(720) 507-4779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4500 Park Granada Ste 202
Calabasas, CA 91302-1666

Mailing address

15355 E Colfax Ave Unit 111717
Aurora, CO 80042-1975
Phone (720) 507-4779

National Provider Directory

National Provider Directory
Tax ID family
Mile High Psychiatry LLC5 organizations share this tax ID, including this one
Part of
Mile High Psychiatry LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1013655737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15355 E COLFAX AVE UNIT 111717",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800421975",
            "telephone_number": "720-507-4779",
            "fax_number": "720-367-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARK GRANADA STE 202",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021666",
            "telephone_number": "720-507-4779",
            "fax_number": "720-367-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILE HIGH PSYCHIATRY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILE HIGH PSYCHIATRY LLC",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "CHISM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-507-4779",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.