Individual provider Active NPI

Anna Sandra Kirby

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1679339915
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
302567 Issued in AZ
Practice address
1201 S 7TH Ave Ste 150
Phoenix, AZ 85007-4075
Phone
(480) 206-4936
NPI assigned
Feb 26, 2024
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 302567 AZ Primary

Addresses

Primary practice location

1201 S 7TH Ave Ste 150
Phoenix, AZ 85007-4075

Mailing address

520 N Stapley Dr Unit 119
Mesa, AZ 85203-7255
Phone (480) 206-3940

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
I20240917003343 AZ Practitioner - Nurse Practitioner 8123569282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Journey of Hope Healing Center LLCGroup PAC ID 0547626855, 2 clinicians

Practice addresses (Care Compare)

6335 E Main St
Suite D
Mesa, AZ 85205-8948
Phone (800) 983-3843

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
302567AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Journey of Hope Healing Center LLC Psychiatric/Mental Health CurrentSince Aug 1, 2024 Accepting new patients
Clearview Health LLC Past Accepting new patients

Locations

6335 E Main St
Ste D
Mesa, AZ 85205
Phone (480) 932-4430

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1679339915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N STAPLEY DR UNIT 119",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852037255",
            "telephone_number": "480-206-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S 7TH AVE STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850074075",
            "telephone_number": "480-206-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "ANNA",
        "middle_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "302567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.