Gia Teresa Accuardi, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Kayenta, AZ
NPI 1629389366 · NPPES record last updated Nov 26, 2018
Key facts
- NPI
- 1629389366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 201050127 (OR)
- Practice address
- Kayenta Health Center
Hwy 160 & MP 394.3
Kayenta, AZ 86033 - Phone
- (928) 697-4183
- Fax
- (928) 697-4189
- NPI assigned
- Jun 28, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DHHS PHS Naihs Chinle Comprehensive Health Care Facility
Practice addresses (Care Compare)
Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030
PO Box PH
Chinle, AZ 86503-8000
Hospital & facility affiliations
- Chinle Comprehensive Health Care Facility
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190129000638 | TX | Practitioner - Nurse Practitioner | 6709123730 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201050127 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kayenta Alternative Rural Hospital | Current | Accepting new patients | |
| Kayenta Alternative Rural Hospital | Current |
Accepting new patients | |
| DHHS PHS Naihs Chinle Comprehensive Health Care Facility | Current | Accepting new patients | |
| Jeffrey J Hansen MD PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 201050127 | OR | Yes |
Addresses
Primary practice location
Kayenta Health Center
Hwy 160 & MP 394.3
Kayenta, AZ 86033
Mailing address
PO Box 368
Kayenta, AZ 86033-0368
Phone (286) 974-1839
Other practice location 1
2215 Broadway St
Cascade Center for Wellness
Vancouver, WA 98663-3226
Phone (360) 906-7156
Other providers in Kayenta, AZ
- Diana Mayerly Acevedo Gordillo
- Edgar Acutin Jr.
- Michele Agnew
- Christopher Leroy Anderson
- Ronalyn Ivy Alindayu Atienza
All providers in Kayenta, AZ · Psychiatric/Mental Health Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.