Kelleen Stiles, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP4126 Issued in AZ

Practice address

1145 Marina Blvd.
Bullhead City, AZ 86442

Phone

(928) 758-5905

NPI assigned

Oct 3, 2010

Last updated

Sep 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Other, 2010

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mohave Mental Health Clinic Inc

  • Clinic/Center
  • Kingman, AZ
  • NPI 1902894272
  Medicare reassignment Care Compare group NPD
• Horizon Health and Wellness, Inc.

  • General Practice Physician
  • Apache Junction, AZ
  • NPI 1659308989
  Medicare reassignment NPD
• Horizon Health and Wellness, Inc.

  • Federally Qualified Health Center (FQHC)
  • Globe, AZ
  • NPI 1689436412
  NPD
• Mohave Mental Health Clinic Inc

  • Community/Behavioral Health Agency
  • Kingman, AZ
  • NPI 1922275692
  NPD
• Southeastern Arizona Behavioral Health Service, Inc

  • Community/Behavioral Health Agency
  • Douglas, AZ
  • NPI 1932620390
  NPD
• Southeastern Arizona Behavioral Health Services, Inc.

  dba Benson Outpatient Treatment Center

  • Community/Behavioral Health Agency
  • Benson, AZ
  • NPI 1760830137
  NPD
• Mohave Mental Health Clinic, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Bullhead City, AZ
  • NPI 1619294865
  NPD (past)
• Mohave Mental Health Clinic, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1912458589
  NPD (past)

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

{
    "created_epoch": "1286064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1437468840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 MARINA BLVD.",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-758-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 MARINA BLVD.",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-758-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "KELLEEN",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-03",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP4126",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F4013321",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Scott Stagg, FNP-C
• Jennifer Staggs, MSW, LCSW
• Blake A Stamper, D.O.
• Lisa A Stanley, APN
• Statewide Express Inc
• Cynthia Joyce Stormo, RN
• Celeste Nicole Stuart, DMD
• Robin Carl Sturms, D.D.S
• Summer's Dawn Center
• Summerside Health PLLC

• Psychiatric/Mental Health Nurse Practitioner in Bullhead City, AZ
• Providers in Bullhead City, 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 9, 2016; 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.