Sheeba Kalappurakkal Divakaran, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

255711 Issued in AZ

Practice address

3601 N 6TH Ave Apt A8
Phoenix, AZ 85013-3738

Phone

(602) 653-3075

NPI assigned

Oct 8, 2020

Last updated

Mar 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bethel Hills Intergrated Healthcare PLLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1578104154

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Native American Connections, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1306331509

  TX

  Medicare reassignment NPD
• Teris Health Services LLC

  • Professional Counselor
  • Phoenix, AZ
  • NPI 1215422126

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Native American Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1568223279
  NPD
• Teri's Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1790374833
  NPD

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1174120489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 N 6TH AVE APT A8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133738",
            "telephone_number": "602-653-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 N 6TH AVE APT A8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133738",
            "telephone_number": "602-653-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVAKARAN",
        "first_name": "SHEEBA",
        "middle_name": "KALAPPURAKKAL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "255711",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "141069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• District Medical Group, Inc
• District Medical Group, Inc
• District Medical Group, Inc
• Ditabell Behavioral Health Care LLC
• Michael James Ditsworth, APRN, FNP-C
• Maribeth Diver, CNM
• Divergent Collective, Inc.
• Caitlin Kelsey Divers, ATC
• Diverse Ability Incorporated
• Divine Anesthesia Care LLC

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.