Deborah M Radford, RN, NPP, M.SC(A)

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP5484 Issued in AZ

Practice address

1741 Sycamore Ave
Kingman, AZ 86409-0927

Phone

(928) 757-8111

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Mrs. Deborah M Moudarres Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

State University of New York at Stony Brook, School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mohave Mental Health Clinic IncGroup PAC ID 7618963935, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• Mohave Mental Health Clinic Inc

  • Clinic/Center
  • Kingman, AZ
  • NPI 1902894272
  Medicare reassignment Care Compare group NPD
• Mohave Mental Health Clinic Inc

  • Psychiatric Hospital Unit
  • Kingman, AZ
  • NPI 1952471518
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Care Compare affiliation

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1295802957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 N STOCKTON HILL RD STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090507",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 SYCAMORE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090927",
            "telephone_number": "928-757-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505-A Western Ave",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "AZ",
            "postal_code": "86409",
            "country_code": "US",
            "telephone_number": "928-757-8111 x2322",
            "fax_number": "928-757-3256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "DEBORAH",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN, NPP, M.SC(A)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "533841",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN184531",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400881",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP5484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "900068",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "MOUDARRES",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "RN, NPP, M.SC(A)",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Muhammad Qaisar
• Quail Ridge Medical LLC
• Morgan T Quinn, PHARMD
• Desiree Lynea Quiroz-Tennefos
• Emmerll Rackley, NP
• Hilary Radler
• Rainbow Transport Service, LLC
• Marissa Vil Racero Rama, OTR/L
• Augusto Ramirez, P.A.
• Eddie A Ramirez, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Kingman, AZ
• Providers in Kingman, 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 Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.