NPIMap

Organization Active NPI

Foothills Psychiatric Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1750901088
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
FOOTHILLS PSYCHIATRIC SERVICES PLLC
Practice address
1921 S Alma School Rd Ste 312
Mesa, AZ 85210-3039
Phone
(480) 608-4877
Fax
(480) 608-4878
NPI assigned
Apr 16, 2020
Last updated
Apr 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Simon GeorgeNPI 1659983542
Title
RN
Phone
(316) 209-7731

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1921 S Alma School Rd Ste 312
Mesa, AZ 85210-3039

Mailing address

3546 E Windmere Dr
Phoenix, AZ 85048-7211
Phone (316) 209-7731

Other practice location 1

3546 E Windmere Dr
Phoenix, AZ 85048-7211
Phone (316) 209-7731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200729003416 AZ Part B Supplier - Clinic/Group Practice 6901236512 Receives reassigned benefits from 4 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1750901088",
    "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": "316-209-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 S ALMA SCHOOL RD STE 312",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103039",
            "telephone_number": "480-608-4877",
            "fax_number": "480-608-4878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3546 E Windmere Dr",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850487211",
            "country_code": "US",
            "telephone_number": "316-209-7731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOOTHILLS PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "316-209-7731"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.