Individual provider Active NPI

Teresa Evette Robinson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1649140922
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
253037 Issued in AZ
Practice address
24871 S Ellsworth Rd Ste 100-162
Queen Creek, AZ 85142-1574
Phone
(480) 269-4106
NPI assigned
Nov 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal Newborn Registered Nurse 163WM0102X 253037 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 253037 AZ Primary

Addresses

Primary practice location

24871 S Ellsworth Rd Ste 100-162
Queen Creek, AZ 85142-1574

Mailing address

24871 S Ellsworth Rd Ste 100-162
Queen Creek, AZ 85142-1574
Phone (480) 269-4106

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260108001093 AZ Practitioner - Nurse Practitioner 0749766814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1166 E Warner Rd
Suite 113
Gilbert, AZ 85296-3065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
253037AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Colibri Vistas Mental Health Psychiatric/Mental Health Current Accepting new patients
Intentional Healing LLC Psychiatric/Mental Health CurrentSince Dec 1, 2025 Accepting new patients

Locations

1166 E Warner Rd
Ste 113
Gilbert, AZ 85296
Phone (480) 815-7311

24871 S Ellsworth Rd
Ste 100162
Queen Creek, AZ 85142
Phone (480) 269-4106

Organizations & group practices 2

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": "1762819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1649140922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24871 S ELLSWORTH RD STE 100-162",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421574",
            "telephone_number": "480-269-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24871 S ELLSWORTH RD STE 100-162",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421574",
            "telephone_number": "480-269-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "TERESA",
        "middle_name": "EVETTE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-11",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "AZ",
            "license": "253037",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "253037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.