Imma Nzomo, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP11526 Issued in AZ

Practice address

1855 W Baseline Rd Ste 101
Mesa, AZ 85202-9098

Phone

(480) 831-7566

NPI assigned

Aug 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Foothills Psychiatric Services PLLCGroup PAC ID 6901236512, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Foothills Psychiatric Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1750901088
  Medicare reassignment Care Compare group NPD
• Sycamore Integrated Health LLC

  • Adult Day Care Clinic/Center
  • Mesa, AZ
  • NPI 1205426053

  Psychiatric/Mental Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1629559976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3546 E WINDMERE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487211",
            "telephone_number": "520-304-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 W BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029098",
            "telephone_number": "480-831-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NZOMO",
        "first_name": "IMMA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP11526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chikwendu C Nwosu, MD
• Nwse: Nicole Warner Shaha Enterprises, LLC
• Jace L Nybo, DC
• Jennifer Nye, LMSW
• Diana Marie Nyren, COTA
• Molly Elizabeth O'Brien I, DO
• Seth O'Brien, CP, FAAOP
• Kristen O'Connor, MS CCC-SLP
• Amy Lynn O'Hara, NMD
• Jacob Patrick O'Horo, EMT

• Psychiatric/Mental Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, 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 Aug 24, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.