Active NPI
Eclipse Psychiatry
- Community/Behavioral Health Agency
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- ECLIPSE PSYCHIATRY
- Practice address
- 2152 S Vineyard Unit 113-114
Mesa, AZ 85210-6871 - Phone
- (623) 282-2047
- NPI assigned
- Jun 10, 2021
- Last updated
- May 24, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Anthony Kimani, PMHNP
- Title
- President
- Phone
- (978) 697-0301
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
2152 S Vineyard Unit 113-114
Mesa, AZ 85210-6871
Mailing address
2152 S Vineyard
Mesa, AZ 85210-6871
Phone (978) 697-0301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295370401 | Medicaid | AZ |
National Provider Directory
National Provider DirectoryLocations
2152 S Vineyard
Mesa, AZ 85210
Phone (480) 539-6646
2152 S Vineyard
Unit 113114
Mesa, AZ 85210
Phone (623) 282-2047
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Mesa, AZ
- NPI 1295370401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623283200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653350400000",
"number": "1043888688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2152 S VINEYARD",
"city": "MESA",
"state": "AZ",
"postal_code": "852106871",
"telephone_number": "978-697-0301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2152 S VINEYARD UNIT 113-114",
"city": "MESA",
"state": "AZ",
"postal_code": "852106871",
"telephone_number": "623-282-2047"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ECLIPSE PSYCHIATRY",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-10",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A",
"authorized_official_last_name": "KIMANI",
"authorized_official_first_name": "ANTHONY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "978-697-0301",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PMHNP"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1295370401",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.