Individual provider Active NPI

Russell Horning, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1669526158
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN105764 Issued in AZ
Practice address
16620 N 40TH St Ste H4
Phoenix, AZ 85032
Phone
(602) 464-9576
Fax
(602) 626-8901
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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 RN105764 AZ Primary

Addresses

Primary practice location

16620 N 40TH St Ste H4
Phoenix, AZ 85032

Mailing address

16620 N 40TH St Ste E-1
Phoenix, AZ 85032-3348
Phone (602) 464-9576

Other practice location 1

2450 E Guadalupe Rd Ste 103
Gilbert, AZ 85234-5116
Phone (480) 907-6818

Other practice location 2

6535 W Camelback Rd Ste 4
Phoenix, AZ 85033-1608
Phone (623) 231-5535

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
I20040203001033 AZ Practitioner - Nurse Practitioner 8123911237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quack Health PLLCGroup PAC ID 5193184505, 7 clinicians

Practice addresses (Care Compare)

3404 W Cheryl Dr
Suite A150
Phoenix, AZ 85051-9615
Phone (602) 503-2832

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
65.06
Promoting interoperability
98
Improvement activities
40
Cost
78.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN105764AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quack Health PLLC Psychiatric/Mental Health CurrentSince Jun 2, 2023 Accepting new patients
Satinder S. Purewal, M.D. LLC CurrentSince Mar 27, 2023 Accepting new patients
Magellan Health Services of Arizona, Inc Past Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients

Locations

6677 W Thunderbird Rd
Ste I164
Glendale, AZ 85306
Phone (623) 878-2100

3404 W Cheryl Dr
Ste A150
Phoenix, AZ 85051
Phone (480) 863-5250

Organizations & group practices 4

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1669526158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST STE E-1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323348",
            "telephone_number": "602-464-9576",
            "fax_number": "602-626-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST STE H4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "602-464-9576",
            "fax_number": "602-626-8901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 E Guadalupe Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852345116",
            "country_code": "US",
            "telephone_number": "480-907-6818",
            "fax_number": "480-907-5181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6535 W Camelback Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850331608",
            "country_code": "US",
            "telephone_number": "623-231-5535",
            "fax_number": "623-231-5978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORNING",
        "first_name": "RUSSELL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN105764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.