Carmen Patricia Born, PMHNP-BC, RN, LMT

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

295014 Issued in AZ

Practice address

35641 W Costa Blanca Dr
Maricopa, AZ 85138-5869

Phone

(443) 823-5908

NPI assigned

Apr 28, 2015

Last updated

Mar 21, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1053798199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35641 W COSTA BLANCA DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385869",
            "telephone_number": "443-823-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35641 W COSTA BLANCA DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385869",
            "telephone_number": "443-823-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORN",
        "first_name": "CARMEN",
        "middle_name": "PATRICIA",
        "credential": "PMHNP-BC, RN, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "295014",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "29408",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Ann Bieber
• Debbie Birt, R.N.
• Agatha Bonsu
• Chambray Boone, RN
• Igor Borisov, DMD
• Andrew Bosak, PT, DPT
• Candice Diane Bourgeois, RN
• Teresa Bourquin, RN
• Megan Bradley
• Colleen Braun, DPT

• Psychiatric/Mental Health Nurse Practitioner in Maricopa, AZ
• Providers in Maricopa, 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 Mar 21, 2024; 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.