Nuphase Health Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NUPHASE HEALTH SERVICES, LLC

Practice address

4225 W Glendale Ave Ste A102
Phoenix, AZ 85051-8195

Phone

(717) 747-6522

NPI assigned

Feb 3, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Qiana Michele Mayberry

Title

Chief Administrative Officer

Phone

(717) 747-6522

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• NuPhase Health Services Doing business as

Tax ID family

Nuphase Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nuphase Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1184372286
  NPD tax ID

Locations

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1427701937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14613 E DESERT VISTA TRL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852627826",
            "telephone_number": "717-747-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 W GLENDALE AVE STE A102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850518195",
            "telephone_number": "717-747-6522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4225 W Glendale Ave Ste B101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850518192",
            "country_code": "US",
            "telephone_number": "623-248-7708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NUPHASE HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-03",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "MAYBERRY",
        "authorized_official_first_name": "QIANA",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "717-747-6522",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164883",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ COUNSELING FACILITY LICENSE",
            "identifier": "CSLG11865",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NuPhase Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randall Nunley, D.D.S.
• Deotis J Nunn, MBA
• Tiffany A Nunnelley, DO
• Jacquline Nunner, PHARMD
• Nuphase Health Services, LLC
• Nuriel Mercy Care LLC
• Nurse at Home LLC
• Nurse Practitioners R US
• Nursecore Management Services LLC
• Nurses Plus Healthcare LLC

• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.