Individual provider Active NPI

Christine Edberg, M.D.

  • Psychiatry Physician
  • Peoria, AZ
National Provider Identifier
1144438441
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
28726 Issued in AZ
Practice address
13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone
(623) 876-3800
Fax
(623) 876-6965
NPI assigned
May 18, 2007
Last updated
Dec 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 28726 AZ Primary

Addresses

Primary practice location

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846

Mailing address

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

Other identifiers 1

IdentifierTypeStateIssuer
939241MedicaidAZ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070808000460 AZ Practitioner - Psychiatry 8628169406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28726AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 7, 2015 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 7, 2015 Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients
Banner Arizona Medical Clinic LTD Past Accepting new patients
Banner Behavioral Health Hospital Past Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

120 E Main St
Ste A
Payson, AZ 85541
Phone (928) 474-9744

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

7575 E Earll Dr
Scottsdale, AZ 85251
Phone (480) 448-7500

7575 E Earll Dr
Bldg 500
Scottsdale, AZ 85251
Phone (480) 941-7500

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1144438441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3800",
            "fax_number": "623-876-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3800",
            "fax_number": "623-876-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDBERG",
        "first_name": "CHRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "28726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "939241",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.