Individual provider Active NPI

Pallavi Rao, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1326618620
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
313389 Issued in AZ
Practice address
40 E Mitchell Dr Ste 100&200
Phoenix, AZ 85012-2330
Phone
(602) 685-6000
Fax
(602) 808-2799
NPI assigned
Jun 29, 2021
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 253580 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 313389 AZ Primary

Addresses

Primary practice location

40 E Mitchell Dr Ste 100&200
Phoenix, AZ 85012-2330

Mailing address

3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Phone (602) 685-6000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250321002241 AZ Practitioner - Nurse Practitioner 3779005400 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
253580TNMDRegistered Nurse
313389AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Terros Inc CurrentSince Jan 21, 2025 Accepting new patients
Terros, Inc. CurrentSince Jan 21, 2025 Accepting new patients
Terros, Inc. Current Accepting new patients
Crystal Clear Psychiatry PLLC Psychiatric/Mental Health Current Accepting new patients
Helen Ross McNabb Center PastSince Jul 1, 2021 Accepting new patients

Locations

3003 N Central Ave
Ste 400
Phoenix, AZ 85012
Phone (602) 351-3015

40 E Mitchell Dr
Ste 100
Phoenix, AZ 85012
Phone (602) 995-7474

40 E Mitchell Dr
Ste 100200
Phoenix, AZ 85012

4909 E McDowell Rd
Phoenix, AZ 85008
Phone (602) 244-9591

8804 N 23rd Ave
Ste A1
Phoenix, AZ 85021

Interoperability endpoints

  • Direct secure messaging: pallavi.rao.p1@direct.lifewell.nextgenshare.com
  • Direct secure messaging: pallavi.rao.p1@direct.terros.nextgenshare.com

Organizations & group practices 5

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1326618620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 E MITCHELL DR STE 100&200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122330",
            "telephone_number": "602-685-6000",
            "fax_number": "602-808-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "PALLAVI",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "253580",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "313389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.