NPIMap

Individual provider Active NPI

Mandi L. Filla, CNP

  • Adult Health Nurse Practitioner
  • Wickenburg, AZ
National Provider Identifier
1144629429
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP8073 Issued in AZ
Practice address
523 Rose LN
Wickenburg, AZ 85390-1448
Phone
(928) 668-1845
Fax
(289) 684-7457
NPI assigned
Aug 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.16305-NP OH
Adult Health Nurse Practitioner 363LA2200X AP8073 AZ Primary

Addresses

Primary practice location

523 Rose LN
Wickenburg, AZ 85390-1448

Mailing address

523 Rose LN
Wickenburg, AZ 85390-1448
Phone (928) 668-1833

Other names 1

  • Mandi L. Hutson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923002487 AZ Practitioner - Nurse Practitioner 7315168572 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

519 Rose LN
Wickenburg, AZ 85390-1448
Phone (928) 684-4365

523 Rose LN
Wickenburg, AZ 85390-1448

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP8073AZMDAdult Health Nurse Practitioner
COA.16305-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Sep 1, 2020 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Community Hospital Association, Inc. CurrentSince Nov 22, 2021 Accepting new patients
Integrated Healthcare Mobile Solutions, LLC Nurse Practitioner CurrentSince Jun 1, 2020 Accepting new patients
District Medical Group, Inc CurrentSince Sep 1, 2020 Accepting new patients
Radiology Associates of Canton, Inc. Past Accepting new patients
Community Hospital Association, Inc. Past Accepting new patients

Locations

570 W Brown Rd
Mesa, AZ 85201
Phone (480) 344-2000

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

1840 E Baseline Rd
Ste A1
Tempe, AZ 85283
Phone (480) 718-5400

1395 W Wickenburg Way
Wickenburg, AZ 85390
Phone (623) 388-9957

523 Rose Ln
Wickenburg, AZ 85390
Phone (928) 668-1833

520 Rose Ln
Wickenburg, AZ 85390
Phone (928) 666-1197

Interoperability endpoints

  • Direct secure messaging: mfilla221653@direct.valleywisehealth.org
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1144629429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 ROSE LN",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901448",
            "telephone_number": "928-668-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 ROSE LN",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901448",
            "telephone_number": "928-668-1845",
            "fax_number": "289-684-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLA",
        "first_name": "MANDI",
        "middle_name": "L.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.16305-NP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP8073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDI",
            "last_name": "HUTSON",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wickenburg, AZ

Sources for this page

Verify at the official NPI Registry.