Active NPI
Fulton & Wilson
Doing business as San Creek Mental Health & Wellness
- Psychiatric/Mental Health Clinical Nurse Specialist
- Mesa, AZ
National Provider Identifier
1184452955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Clinical Nurse Specialist
- Legal business name
- FULTON & WILSON
- Doing business as
- San Creek Mental Health & Wellness
- Practice address
- 560 W Brown Rd Ste 1011
Mesa, AZ 85201-3222 - Phone
- (520) 614-8645
- Fax
- (520) 277-7480
- NPI assigned
- Jul 23, 2024
- Organization subpart
- Yes
- Parent organization
- FULTON & WILSON
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Troy Fulton, PMHNP
- Title
- Ceo
- Phone
- (520) 614-8645
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 Clinical Nurse Specialist | 364SP0808X | Primary |
Addresses
Primary practice location
560 W Brown Rd Ste 1011
Mesa, AZ 85201-3222
Mailing address
560 W Brown Rd Ste 1011
Mesa, AZ 85201-3222
Phone (520) 614-8645
Other names 1
- SAN CREEK MENTAL HEALTH & WELLNESS
National Provider Directory
National Provider Directory- Part of
- Fulton Wilson
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Mesa, AZ
- NPI 1053937599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721692800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721692800000",
"number": "1184452955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 W BROWN RD STE 1011",
"city": "MESA",
"state": "AZ",
"postal_code": "852013222",
"telephone_number": "520-614-8645",
"fax_number": "520-277-7480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 W BROWN RD STE 1011",
"city": "MESA",
"state": "AZ",
"postal_code": "852013222",
"telephone_number": "520-614-8645",
"fax_number": "520-277-7480"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FULTON & WILSON",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FULTON & WILSON",
"enumeration_date": "2024-07-23",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A",
"authorized_official_last_name": "FULTON",
"authorized_official_first_name": "TROY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "520-614-8645",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PMHNP"
},
"taxonomies": [
{
"code": "364SP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SAN CREEK MENTAL HEALTH & WELLNESS",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.