Active NPI
Serenity Healthy Minds and Telemedicine Wellness LLC
- Psychiatric/Mental Health Nurse Practitioner
- Queen Creek, AZ
National Provider Identifier
1184413023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- SERENITY HEALTHY MINDS AND TELEMEDICINE WELLNESS LLC
- Practice address
- 24871 S Ellsworth Rd
Ste 100 PMB 146
Queen Creek, AZ 85142 - Phone
- (480) 979-8273
- NPI assigned
- May 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ethel Oluyemisi Winfunke-Rochin
- Title
- Owner
- Phone
- (480) 508-0774
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
24871 S Ellsworth Rd
Ste 100 PMB 146
Queen Creek, AZ 85142
Mailing address
24871 S Ellsworth Rd Ste 100
Queen Creek, AZ 85142-1575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Serenity Healthy Minds and Telemedicine Wellness LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatric/Mental Health Nurse Practitioner
- Queen Creek, AZ
- NPI 1922974773
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Gilbert, AZ
- NPI 1588052823
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1769990400000",
"number": "1184413023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24871 S ELLSWORTH RD STE 100",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851421575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24871 S ELLSWORTH RD",
"address_2": "STE 100 PMB 146",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "85142",
"telephone_number": "480-979-8273"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SERENITY HEALTHY MINDS AND TELEMEDICINE WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-05-06",
"last_updated": "2026-02-02",
"certification_date": "2026-02-02",
"status": "A",
"authorized_official_last_name": "WINFUNKE-ROCHIN",
"authorized_official_first_name": "ETHEL",
"authorized_official_middle_name": "OLUYEMISI",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "480-508-0774"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.