Individual provider Active NPI

Patricia K Kennedy, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Apache Junction, AZ
National Provider Identifier
1760417489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN055120 Issued in AZ
Practice address
150 N Ocotillo Dr
Apache Junction, AZ 85220-3740
Phone
(480) 983-0571
Fax
(480) 983-0896
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RN055120 AZ Primary

Addresses

Primary practice location

150 N Ocotillo Dr
Apache Junction, AZ 85220-3740

Mailing address

PO Box 3160
Apache Junction, AZ 85217-3160
Phone (480) 288-5328

Other identifiers 1

IdentifierTypeStateIssuer
470021MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Terros Inc Past Accepting new patients
Horizon Health and Wellness, Inc. Psychiatric/Mental Health Past Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients
Magellan Health Services of Arizona, Inc Past Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients

Organizations & group practices 6

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760417489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3160",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852173160",
            "telephone_number": "480-288-5328",
            "fax_number": "480-288-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N OCOTILLO DR",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852203740",
            "telephone_number": "480-983-0571",
            "fax_number": "480-983-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "PATRICIA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN055120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470021",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.