Kenneth Scott Gifford, CFRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Tucson, AZ
NPI 1871299545 · NPPES record last updated Nov 8, 2023
Key facts
- NPI
- 1871299545
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 295155 (AZ)
- Practice address
- 3395 N Campbell Ave
Tucson, AZ 85719-2306 - Phone
- (520) 307-4790
- NPI assigned
- Feb 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231019002559 | AZ | Practitioner - Nurse Practitioner | 6103272646 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 295155 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Building Blocks Counseling LLC | Past | Accepting new patients | |
| Building Blocks Counseling,LLC | Past | Accepting new patients | |
| Building Blocks Counseling LLC | Past |
Accepting new patients | |
| BBC Whitton, LLC | Past | Accepting new patients |
Interoperability endpoints
- ken.giffordnp.p1@direct.cbridges.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 295155 | AZ | Yes |
Addresses
Primary practice location
3395 N Campbell Ave
Tucson, AZ 85719-2306
Mailing address
3395 N Campbell Ave
Tucson, AZ 85719-2306
Phone (520) 771-6782
Other providers in Tucson, AZ
- Shanieka Gibson
- Barbara L Giddens
- Charles B Giffin
- Stephanie Marie Franquemont Giffin
- Heidi Elizabeth Gifford
- Grace Gigliotti
- Zachariah Giguere
- Karelia Gil-Navarro
- Deana Elis Gil
- Leticia Lopez Gil
All providers in Tucson, AZ · Psychiatric/Mental Health Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.