Phoenix Rising Telepsych

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PHOENIX RISING TELEPSYCH

Practice address

6917 Tomahawk Rd
Prairie Village, KS 66208-2618

Phone

(913) 398-2530

NPI assigned

May 22, 2024

Organization subpart

No

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

Authorized official

Name

Jaclyn McIntyre, APRNNPI 1326763038

Title

Owner

Phone

(913) 398-2530

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jaclyn A McIntyre, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Smithville, MO
  • NPI 1326763038
  NPD (past) Authorized official

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1144069790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8544",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662080544",
            "telephone_number": "913-398-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6917 TOMAHAWK RD",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662082618",
            "telephone_number": "913-398-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING TELEPSYCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-398-2530",
        "authorized_official_credential": "APRN"
    },
    "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": []
}

• Kylie Peters, RBT
• Michelle Lynn Petersen, D.D.S.
• Conner Peterson
• Lyn Brooks Petro
• Kelly Nicole Pettit
• Physicians Reference Laboratory LLC
• Physicians' Surgery Center, LLC
• Hannah Faith Pierce
• Marion Spence Pierson, MD
• Christina Anne Pinkley, HIS, BC

• Psychiatric/Mental Health Nurse Practitioner in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.