Active NPI
Hughes Mohlie, ANP
- Psychiatric/Mental Health Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1497065486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- AP5113
- Practice address
- 7828 N 19TH Ave Ste 10
Phoenix, AZ 85021-7044 - Phone
- (602) 666-1667
- Fax
- (480) 566-0247
- NPI assigned
- Oct 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP5113 | AZ | Primary |
Addresses
Primary practice location
7828 N 19TH Ave Ste 10
Phoenix, AZ 85021-7044
Mailing address
7828 N 19TH Ave Ste 10
Phoenix, AZ 85021-7044
Phone (602) 923-0436
Other practice location 1
150 E Tyson Street
Quartzsite, AZ 85359-4618
Phone (928) 927-8747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 895664 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP5113 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Paz Regional Hospital Inc | Current | Accepting new patients | |
| Mission City Community Network, Inc. | Current | Accepting new patients | |
| Mission City Community Network, Inc. | Current | Accepting new patients | |
| Mission City Community Network, Inc. | Current | Accepting new patients | |
| Culver City Psychological Associates, Inc. | Past | Accepting new patients |
Locations
15206 Parthenia St
Sepulveda, CA 91343
Interoperability endpoints
- hughesmohlie@lprh.medalliesdirect.net
Organizations & group practices 5
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hollywood, CA
- NPI 1710102009
-
- Critical Access Hospital
- Parker, AZ
- NPI 1053684555
-
- Primary Care Clinic/Center
- Monrovia, CA
- NPI 1063795250
-
- Community Health Clinic/Center
- North Hills, CA
- NPI 1710370747
-
- Clinical Psychologist
- Culver City, CA
- NPI 1689684607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1497065486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7828 N 19TH AVE STE 10",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850217044",
"telephone_number": "602-923-0436",
"fax_number": "480-566-0247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7828 N 19TH AVE STE 10",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850217044",
"telephone_number": "602-666-1667",
"fax_number": "480-566-0247"
}
],
"practiceLocations": [
{
"address_1": "150 E Tyson Street",
"address_purpose": "LOCATION",
"city": "Quartzsite",
"state": "AZ",
"postal_code": "853594618",
"country_code": "US",
"telephone_number": "928-927-8747",
"fax_number": "928-927-8748",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOHLIE",
"first_name": "HUGHES",
"credential": "ANP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-08",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "AZ",
"license": "AP5113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "895664",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
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 Apr 24, 2019; 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.