Shuntelle Hawk, FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN138878 Issued in AZ

Practice address

1250 S Clearview Ave
Suite 100
Mesa, AZ 85209-3378

Phone

(480) 663-2430

NPI assigned

Jan 20, 2015

Last updated

Jun 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shuntelle Whiteside Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FGCDDD
• Direct secure messaging: shuntelle.hawk.p1@direct.lafrontera-empact.nextgenshare.com
• Direct secure messaging: shuntelle.hawk.p1@direct.terros.nextgenshare.com

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

• Terros Inc

  dba Terros Health - University Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
  • NPI 1356202360
  NPD
• Terros, Inc.

  dba Terros Health

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1841498060
  NPD
• Alevea Mental Health LLC

  • Physician Assistant
  • Tempe, AZ
  • NPI 1619482478

  Psychiatric/Mental Health

  NPD (past)
• Empact - Suicide Prevention Center

  dba Empact-SPC

  • Community/Behavioral Health Agency
  • San Tan Valley, AZ
  • NPI 1215311378
  NPD (past)
• Empact Suicide Prevention Center Inc

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1659414969
  NPD (past)
• Mach 1 Medical LLC

  dba US CareWays

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1730608977
  NPD (past)
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141
  NPD (past)

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1033508635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CLEARVIEW AVE",
            "address_2": "SUITE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093378",
            "telephone_number": "480-663-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWK",
        "first_name": "SHUNTELLE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-20",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7573",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN138878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUNTELLE",
            "last_name": "WHITESIDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Michelle Havens, ND
• Hanna Maria Haverinen, PHD, NMD
• Clarin Havig, R.N.
• Matthew Havranek, ATC
• Courtney Hawes, ND
• Michael Christopher Hawkes, NP-C
• Nicole Hawking, P.A.
• Andrea Jane-Marie Hawkins, AU.D.
• Anne Marie Hawkins, M.D.
• Kiley Denae Hawkins

• Psychiatric/Mental Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.