Active NPI
Nannette Newton
- Mental Illness Community Based Residential Treatment Facility
- Surprise, AZ
National Provider Identifier
1013663640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- BH7304
- Practice address
- 16415 N 168TH Ave
Surprise, AZ 85388-1330 - Phone
- (520) 582-7396
- NPI assigned
- Feb 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child Mental Illness Respite Care | 385HR2055X | BH7304 | AZ | |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | BH7304 | AZ | Primary |
Addresses
Primary practice location
16415 N 168TH Ave
Surprise, AZ 85388-1330
Mailing address
2025 N 3Rd St Ste 300
Phoenix, AZ 85004-1486
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH7304 | AZ | MD | Mental Illness Community Based Residential Treatment Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714521600000",
"number": "1013663640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 N 3RD ST STE 300",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850041486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16415 N 168TH AVE",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853881330",
"telephone_number": "520-582-7396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWTON",
"first_name": "NANNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-22",
"last_updated": "2024-05-01",
"certification_date": "2024-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": "AZ",
"license": "BH7304",
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "AZ",
"license": "BH7304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.