Grand Canyon Psychiatric Services PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

GRAND CANYON PSYCHIATRIC SERVICES PLLC

Doing business as

Grand Canyon Psychiatric Services

Practice address

28581 N Clover Cir
San Tan Valley, AZ 85143-5869

Phone

(316) 371-9196

NPI assigned

Apr 3, 2023

Last updated

Nov 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter Njogu, APRNNPI 1437862257

Title

Ceo

Phone

(316) 371-9196

Specialties & licenses 1

Addresses

Other names 1

• Grand Canyon Psychiatric Services Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ, WA2 enrollments

Enrollment records 2

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Njogu

  • Psychiatric/Mental Health Nurse Practitioner
  • San Tan Valley, AZ
  • NPI 1437862257

  WA

  Medicare reassignment Care Compare group NPD Authorized official
• Anne N Ngaruiya

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1962109785
  Medicare reassignment Care Compare group NPD
• Loukisha Monique Roberts-Higgenbotham, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Swainsboro, GA
  • NPI 1235527144

  AZ, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1609571173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28581 N CLOVER CIR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435869",
            "telephone_number": "316-371-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28581 N CLOVER CIR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435869",
            "telephone_number": "316-371-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND CANYON PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "NJOGU",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "316-371-9196",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Canyon Psychiatric Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grand Canyon Psychiatric Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in San Tan Valley, AZ
• Providers in San Tan Valley, 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 Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.