Eclipse Psychiatry, PLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ECLIPSE PSYCHIATRY, PLC

Practice address

21300 N John Wayne Pkwy Ste 103
Maricopa, AZ 85139-8964

Phone

(308) 224-4101

NPI assigned

Feb 25, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Paula Danielle Brungardt, DNP, APRN

Title

Nurse Practitioner, Owner

Phone

(308) 224-4101

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1023642360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 I AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478422",
            "telephone_number": "308-224-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 N JOHN WAYNE PKWY STE 103",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851398964",
            "telephone_number": "308-224-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECLIPSE PSYCHIATRY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "BRUNGARDT",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER, OWNER",
        "authorized_official_telephone_number": "308-224-4101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paula@eclipsepsychiatry.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21300 N John Wayne Pkwy Ste 103",
            "city": "Maricopa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "851398964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.