Individual provider Active NPI

Kerby B McDonald, APMHNP-BC

  • Neurology Physician
  • Chandler, AZ
National Provider Identifier
1053662007
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
AP9678 Issued in AZ
Practice address
2201 W Fairview St Ste 1
Chandler, AZ 85224-4712
Phone
(480) 800-4890
Fax
(480) 427-4766
NPI assigned
Sep 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R860526 MS
Neurology Physician 2084N0400X AP9678 AZ Primary

Addresses

Primary practice location

2201 W Fairview St Ste 1
Chandler, AZ 85224-4712

Mailing address

2201 W Fairview St Ste 1
Chandler, AZ 85224-4712
Phone (480) 800-4890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170105001915 AZ Practitioner - Nurse Practitioner 4486805587 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology Associates of the East Valley PLCGroup PAC ID 1850607151, 12 clinicians

Practice addresses (Care Compare)

2201 W Fairview St
Suite 1
Chandler, AZ 85224-4712
Phone (480) 800-4890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP9678AZMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health and Wellness, Inc. Current Accepting new patients
Horizon Health and Wellness, Inc. CurrentSince Dec 30, 2017 Accepting new patients
Sierra Vista Regional Health Center Medical Group LLC CurrentSince Dec 15, 2017 Accepting new patients
Neurology Associates of the East Valley, PLC Neurology CurrentSince Jan 1, 2017 Accepting new patients
Garden Park Past Accepting new patients
Horizon Health and Wellness, Inc. Neurology Past Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients

Locations

625 N Plaza Dr
Apache Junction, AZ 85120
Phone (480) 282-6278

2201 W Fairview St
Ste 1
Chandler, AZ 85224
Phone (480) 389-2798

3308 N Higley Rd
Ste 103
Mesa, AZ 85215
Phone (480) 800-4890

5700 E Highway 90
Fl 4
Sierra Vista, AZ 85635
Phone (520) 263-3500

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1348876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053662007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 W FAIRVIEW ST STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244712",
            "telephone_number": "480-800-4890",
            "fax_number": "480-427-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 W FAIRVIEW ST STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244712",
            "telephone_number": "480-800-4890",
            "fax_number": "480-427-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "KERBY",
        "middle_name": "B",
        "credential": "APMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R860526",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "AP9678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.