Organization Active NPI

Pride Behavioral Health

  • Adult Psychiatric/Mental Health Registered Nurse
  • Chandler, AZ
National Provider Identifier
1134549579
Registry record updated Dec 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
Legal business name
PRIDE BEHAVIORAL HEALTH
Practice address
4960 S Gilbert Rd Ste 109
Chandler, AZ 85249-6023
Phone
(928) 326-6082
Fax
(866) 812-0853
NPI assigned
Apr 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2022

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

Authorized official

Name
Miss Rebecca L James, PNP-BCNPI 1851485783
Title
Ceo
Phone
(602) 326-9135

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
Adult Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0809X Primary

Addresses

Primary practice location

4960 S Gilbert Rd Ste 109
Chandler, AZ 85249-6023

Mailing address

4960 S Gilbert Rd Ste 109
Chandler, AZ 85249-6023
Phone (928) 326-6082

Other identifiers 2

IdentifierTypeStateIssuer
Z184979OtherAZPTAN
922548MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL office@pridebh.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160211000366 AZ Part B Supplier - Clinic/Group Practice 3375847312 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Locations

4960 S Gilbert Rd
Ste 1
Chandler, AZ 85249
Phone (602) 796-8263

2487 S Gilbert Rd
Ste 106180
Gilbert, AZ 85295

1041 S Lebaron
Ste P
Mesa, AZ 85210
Phone (480) 788-4628

Practitioners & affiliated clinicians

Practitioners 1

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": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671321600000",
    "number": "1134549579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 S GILBERT RD STE 109",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852496023",
            "telephone_number": "928-326-6082",
            "fax_number": "866-812-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 S GILBERT RD STE 109",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852496023",
            "telephone_number": "928-326-6082",
            "fax_number": "866-812-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2022-12-18",
        "certification_date": "2022-12-18",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-326-9135",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PNP-BC"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z184979",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922548",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office@pridebh.com",
            "affiliation": "N",
            "endpointDescription": "HIPPA secured office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4960 S Gilbert Rd Ste 109",
            "city": "Chandler",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852496023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2022; 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.