Individual provider Active NPI

Hughes Mohlie, ANP

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1497065486
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP5113 Issued in AZ
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

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
895664MedicaidAZ

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140514002125 CA Practitioner - Nurse Practitioner 5698998979 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP5113AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Paz Regional Hospital Inc Current Accepting new patients
Mission City Community Network, Inc. Current Accepting new patients
Mission City Community Network, Inc. CurrentSince Nov 2, 2019 Accepting new patients
Mission City Community Network, Inc. CurrentSince Nov 2, 2019 Accepting new patients
Culver City Psychological Associates, Inc. Past Accepting new patients

Locations

15206 Parthenia St
Sepulveda, CA 91343

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.