Individual provider Active NPI

Anneli Kumpula, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1336480243
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP4902 Issued in AZ
Practice address
7227 W Bluefield Ave
Glendale, AZ 85308-8115
Phone
(623) 776-5366
Fax
(623) 252-0575
NPI assigned
Mar 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0003350 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP4902 AZ Primary
Family Nurse Practitioner 363LF0000X AP4902 AZ

Addresses

Primary practice location

7227 W Bluefield Ave
Glendale, AZ 85308-8115

Mailing address

7227 W Bluefield Ave
Glendale, AZ 85308-8115
Phone (623) 776-5366

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
I20131122000508 AZ Practitioner - Nurse Practitioner 3072749001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Univeristy of Texas Rio Grande Valley Med School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Roomservice-DoctorcareGroup PAC ID 3870534811, 4 clinicians

Practice addresses (Care Compare)

41601 N Deer Trail Rd
Cave Creek, AZ 85331-2848
Phone (602) 690-7537

Hospital & facility affiliations

  • Elevate Hospice and Palliative Care LLC Hospice, Scottsdale, AZ, CCN 031706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP4902AZMDFamily Nurse Practitioner
C-APN.0003350COMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MD Roomservice-Doctorcare CurrentSince Sep 28, 2013 Accepting new patients
Arizona Wound Healers LLC PastSince May 14, 2023 Accepting new patients

Locations

7010 E Acoma Dr
Ste 102
Scottsdale, AZ 85254
Phone (480) 575-0576

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
WellskyScottsdale, AZ, CCN 031706 Hospice 5% Or Greater Direct Ownership Interest (25%)
Corporate Officer (25%)
Apr 15, 2019
Apr 15, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1336480243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 W BLUEFIELD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088115",
            "telephone_number": "623-776-5366",
            "fax_number": "623-252-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 W BLUEFIELD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088115",
            "telephone_number": "623-776-5366",
            "fax_number": "623-252-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMPULA",
        "first_name": "ANNELI",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-04",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0003350",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP4902",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.