Misty Autumn McGillem, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP9889 Issued in AZ

Practice address

3939 S Park Ave
Tucson, AZ 85714-1635

Phone

(520) 333-4320

NPI assigned

Apr 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Lafrontera Center Inc.

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1073614905
  NPD
• Community Partners Integrated Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1669897385
  NPD (past)
• Millennium Health and Balance PLLC

  • Clinic/Center
  • Tucson, AZ
  • NPI 1942663943
  NPD (past)

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467847822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113509",
            "telephone_number": "520-325-4268",
            "fax_number": "520-318-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 S PARK AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857141635",
            "telephone_number": "520-333-4320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5055 E Broadway Blvd Ste A200",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857113649",
            "country_code": "US",
            "telephone_number": "520-901-4800",
            "fax_number": "520-901-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "504 W 29th St",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857133353",
            "country_code": "US",
            "telephone_number": "520-296-3296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGILLEM",
        "first_name": "MISTY",
        "middle_name": "AUTUMN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP9889",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN 175929",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235041",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Michael McGhee, MD
• Rachel McGhee
• Roger Lee McGhee, R. PH.
• Susan Widener McGhee, PHARMD
• Nancy H McGibbon, MS, PT, HPCS
• Marjorie Elaine McGinnis, COTA
• Woody McGinnis
• Alexandra Jodelle McGlamery, F.N.P.
• Emily R McGlamery, PHARMD
• Jacquelyn G McGlamery, N.P.

• Psychiatric/Mental Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, 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 Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.