Individual provider Active NPI

Charlyn Ponds

  • Child Mental Illness Respite Care
  • Chandler, AZ
National Provider Identifier
1285276345
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Mental Illness Respite CareTaxonomy code 385HR2055X
License
8091955 Issued in AZ
Practice address
235 E Ray Rd Apt 2035
Chandler, AZ 85225-3362
Phone
(480) 692-9136
NPI assigned
Oct 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 8091955 AZ Primary

Addresses

Primary practice location

235 E Ray Rd Apt 2035
Chandler, AZ 85225-3362

Mailing address

235 E Ray Rd Apt 2035
Chandler, AZ 85225-3362

Other identifiers 1

IdentifierTypeStateIssuer
8091955OtherAZAZ DEPT OF HEALTH SERVICES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8091955AZMDChild Mental Illness Respite Care

Practice roles

OrganizationSpecialtyStatusNew patients
The Devereux Foundation Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1285276345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E RAY RD APT 2035",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852253362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E RAY RD APT 2035",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852253362",
            "telephone_number": "480-692-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDS",
        "first_name": "CHARLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "8091955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT OF HEALTH SERVICES",
            "identifier": "8091955",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.