Organization Active NPI

Hazelwood Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1114790078
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HAZELWOOD MENTAL HEALTH
Practice address
7514 E Monterey Way Ste 4
Scottsdale, AZ 85251-6900
Phone
(480) 209-2136
NPI assigned
Nov 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Chyllia Dixon, NURSE PRACTITIONERNPI 1174916472
Title
Owner, Pmhnp
Phone
(809) 495-7004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

7514 E Monterey Way Ste 4
Scottsdale, AZ 85251-6900

Mailing address

7514 E Monterey Way Ste 4
Scottsdale, AZ 85251-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240404002110 AZ Part B Supplier - Clinic/Group Practice 8426496845 Receives reassigned benefits from 2 practitioners
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

7514 E Monterey Way
Scottsdale, AZ 85251

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1114790078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 E MONTEREY WAY STE 4",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7514 E MONTEREY WAY STE 4",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516900",
            "telephone_number": "480-209-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZELWOOD MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-02",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "CHYLLIA",
        "authorized_official_title_or_position": "OWNER, PMHNP",
        "authorized_official_telephone_number": "809-495-7004",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.