NPIMap

Organization Active NPI

Integrated Healthcare Mobile Solutions, LLC

  • Family Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1255749982
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
INTEGRATED HEALTHCARE MOBILE SOLUTIONS, LLC
Practice address
1840 E Baseline Rd Ste A1
Tempe, AZ 85283-1527
Phone
(480) 718-5400
Fax
(877) 666-4624
NPI assigned
Jul 25, 2014
Last updated
Jan 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Authorized official

Name
Brooke W Eisenhart, NPNPI 1891026639
Title
Ceo
Phone
(480) 718-5400

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AZ Primary
Optometrist 152W00000X AZ
Podiatrist 213E00000X NU

Addresses

Primary practice location

1840 E Baseline Rd Ste A1
Tempe, AZ 85283-1527

Mailing address

PO Box 308
Queen Creek, AZ 85142-1806
Phone (480) 718-5400

Other practice location 1

19350 E Silver Creek Ln
Queen Creek, AZ 85142-9064
Phone (480) 718-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20141010002190 AZ Part B Supplier - Clinic/Group Practice 6406076504 Receives reassigned benefits from 22 practitioners
Practice locations: Chandler, AZ; Tempe, AZ
O20180426001907 AZ DME Supplier - Nurse PractitionerDME Supplier - Nursing Facility Intermediate CareDME Supplier - Certified Clinical Nurse SpecialistDME Supplier - Physician - PodiatryDME Supplier - Unknown Supplier/Provider 6406076504 Practice locations: Chandler, AZ

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1255749982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421806",
            "telephone_number": "480-718-5400",
            "fax_number": "877-666-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 E BASELINE RD STE A1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831527",
            "telephone_number": "480-718-5400",
            "fax_number": "877-666-4624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19350 E Silver Creek Ln",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851429064",
            "country_code": "US",
            "telephone_number": "480-718-5400",
            "fax_number": "877-666-4624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED HEALTHCARE MOBILE SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-25",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "EISENHART",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-718-5400",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.

Verify at the official NPI Registry.