Individual provider Active NPI

Emmanuel Ade Epie

  • Psychiatric Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1487932893
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
BH3872 Issued in AZ
Practice address
7204 W Pueblo Ave
Phoenix, AZ 85043-2037
Phone
(623) 440-7423
NPI assigned
Aug 2, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X AZ
Psychiatric Residential Treatment Facility 323P00000X
Psychiatric Residential Treatment Facility 323P00000X BH3872 AZ Primary

Addresses

Primary practice location

7204 W Pueblo Ave
Phoenix, AZ 85043-2037

Mailing address

1638 E Greenway Rd
Phoenix, AZ 85042-5788
Phone (602) 481-9789

Other practice location 1

1638 E Greenway Rd
Phoenix, AZ 85042-5788
Phone (602) 481-9789

Other names 1

  • Mr. Emmanuel Ade Epie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BH3872AZMDPsychiatric Residential Treatment Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Emmarie Behavioral Home Care. LLC Psychiatric Residential Treatment Facility CurrentSince Mar 31, 2024 Accepting new patients

Organizations & group practices 1

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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1487932893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 E GREENWAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425788",
            "telephone_number": "602-481-9789",
            "fax_number": "602-268-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7204 W PUEBLO AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850432037",
            "telephone_number": "623-440-7423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 E Greenway Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850425788",
            "country_code": "US",
            "telephone_number": "602-481-9789",
            "fax_number": "602-268-1248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EPIE",
        "first_name": "EMMANUEL",
        "middle_name": "ADE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AZ",
            "license": "BH3872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMANUEL",
            "last_name": "EPIE",
            "middle_name": "ADE",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.