Blue Horse Medical, LLC

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

Legal business name

BLUE HORSE MEDICAL, LLC

Practice address

41818 N Venture Dr Ste 150
Anthem, AZ 85086-3190

Phone

(623) 400-1501

Fax

(623) 246-4224

NPI assigned

Jul 12, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Todd A Adams, APRNNPI 1013514421

Title

Owner

Phone

(623) 400-1501

Specialties & licenses 2

Addresses

Other names 1

• Anthem Psychiatry Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd A Adams, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Anthem, AZ
  • NPI 1013514421

  Addiction Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1821660671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39506 N DAISY MOUNTAIN DR STE 122418",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850866078",
            "telephone_number": "623-400-1501",
            "fax_number": "623-246-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41818 N VENTURE DR STE 150",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850863190",
            "telephone_number": "623-400-1501",
            "fax_number": "623-246-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HORSE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-400-1501",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.anthempsychiatry.com",
            "affiliation": "N",
            "endpointDescription": "corporate website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "physical address",
            "address_1": "41818 N Venture Dr Ste 150",
            "city": "Anthem",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850863190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Anthem Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Addiction Medicine (Psychiatry & Neurology) Physician in Anthem, AZ
• Providers in Anthem, AZ by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.