Kay Lynn Southwell, PMHNP-BC,NPC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP8742 Issued in AZ

Practice address

1910 S Stapley Dr Ste 217
Mesa, AZ 85204-6679

Phone

(602) 888-0370

NPI assigned

Mar 23, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kay Lynn Southern Former name

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119
• Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaylynn.southwell@57560418353156.direct.elationemr.com

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.

• Innovative Primary Care LLC

  • Legal Medicine
  • Gilbert, AZ
  • NPI 1669437349
  Medicare reassignment NPD
• Kmtrask, PLLC

  • Nurse Practitioner
  • Gilbert, AZ
  • NPI 1518413962
  Medicare reassignment NPD
• San Tan Psychiatry PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
  • NPI 1437936655
  NPD
• Aloha Cardiology P.C.

  • Specialist
  • Gilbert, AZ
  • NPI 1659703650
  NPD (past)
• Genesys Integrated Group Practice PC

  • Nurse Practitioner
  • Flint, MI
  • NPI 1386782381
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Community Care

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1992735088
  Care Compare affiliation

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1730320623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7156 E OLLA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852129802",
            "telephone_number": "810-919-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 217",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046679",
            "telephone_number": "602-888-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWELL",
        "first_name": "KAY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC,NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704216251",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP8742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "0B56065",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "0B56065",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAY",
            "last_name": "SOUTHERN",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Cathleen South, PSY.D.
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• Southeast Valley Urology PC
• Southern Medical Group LLC
• Southern Square Dentistry PLC
• Southwest Behavioral Health Services
• Southwest Behavioral Health Services
• Southwest Behavioral Health Services, Inc.
• Southwest Behavioral Health Services, Inc.
• Southwest Cardiovascular Interventional Center, LLC

• 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 Sep 30, 2024; 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.