Anthony Wanjohi Kimani

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

234197 Issued in AZ

Practice address

2152 S Vineyard Ste 113-114
Mesa, AZ 85210-6871

Phone

(623) 282-2047

NPI assigned

Nov 12, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Eclipse Psychiatry Outpatient Treatment Center PLLC

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1114664570
  NPD Authorized official

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1295370401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22647 E PARKSIDE DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429507",
            "telephone_number": "623-282-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 S VINEYARD STE 113-114",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106871",
            "telephone_number": "623-282-2047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22647 E Parkside Dr",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851429507",
            "country_code": "US",
            "telephone_number": "623-282-2047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMANI",
        "first_name": "ANTHONY",
        "middle_name": "WANJOHI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-12",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "234197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayun Kim, ANP-C
• Jae H. Kim, M.D.
• Krista Maria Kim, ATC
• Sarah Kim
• Youjong Kim
• Sarah Kimani
• Crozier Rodney Kimball Jr., LPC
• Meghan A Kimball, EDS
• Catherine Dayne Kimble, DMD
• Jacqueline A Kinard, LMSW

• Psychiatric/Mental Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, 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 May 24, 2022; 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.