Individual provider Active NPI

Regina Barbara Namatovu, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1407554645
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
290096 Issued in AZ
Practice address
1936 E Saint Anne Ave
Phoenix, AZ 85042-9100
Phone
(214) 772-4835
NPI assigned
Feb 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1111082 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 290096 AZ Primary

Addresses

Primary practice location

1936 E Saint Anne Ave
Phoenix, AZ 85042-9100

Mailing address

2915 Albares
Grand Prairie, TX 75054-6511
Phone (214) 772-4835

Other practice location 1

2915 Albares
Grand Prairie, TX 75054-6511
Phone (214) 772-4835

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
I20230821000704 AZ Practitioner - Nurse Practitioner 6406218676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connectionsaz LLCGroup PAC ID 3072858745, 39 clinicians

Practice addresses (Care Compare)

1201 S 7TH Ave
Suite 150
Phoenix, AZ 85007-4075
Phone (602) 253-5100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1111082TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connectionsaz, LLC CurrentSince Jul 8, 2023 Accepting new patients
Connectionsaz, LLC CurrentSince Jul 8, 2023 Accepting new patients
Connectionsaz, LLC Current Accepting new patients

Locations

1201 S 7th Ave
Ste 150
Phoenix, AZ 85007
Phone (602) 253-5100

Interoperability endpoints

  • Direct secure messaging: regina.namatovu@mmconnections.contexture.medalliesmail.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1407554645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 ALBARES",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750546511",
            "telephone_number": "214-772-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 E SAINT ANNE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850429100",
            "telephone_number": "214-772-4835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2915 Albares",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750546511",
            "country_code": "US",
            "telephone_number": "214-772-4835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAMATOVU",
        "first_name": "REGINA",
        "middle_name": "BARBARA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1111082",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "290096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.