NPIMap

Organization Active NPI

Pool of Bethesda Psychiatric Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Surprise, AZ
National Provider Identifier
1881240760
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
POOL OF BETHESDA PSYCHIATRIC HEALTH LLC
Practice address
18747 N Reems Rd Ste 500
Surprise, AZ 85374-8645
Phone
(877) 396-5133
Fax
(520) 526-9962
NPI assigned
Aug 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Dr. Stephanie F Hancock, DNP, ARNP. PMHNP-BCNPI 1639634777
Title
Owner of Entity
Phone
(520) 333-4949

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

18747 N Reems Rd Ste 500
Surprise, AZ 85374-8645

Mailing address

18747 N Reems Rd Ste 500
Surprise, AZ 85374-8645
Phone (877) 396-5133

Other practice location 1

210 W Continental Rd Ste 216B
Green Valley, AZ 85622-3596
Phone (520) 333-4949

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@pobpsychiatry.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190926002902 AZ Part B Supplier - Clinic/Group Practice 9830429273 Receives reassigned benefits from 7 practitioners
Practice locations: Green Valley, AZ; Surprise, AZ

National Provider Directory

National Provider Directory

Locations

210 W Continental Rd
Ste 244A
Green Valley, AZ 85622
Phone (520) 333-4949

210 W Continental Rd
Ste 229
Green Valley, AZ 85622
Phone (520) 329-1579

18747 N Reems Rd
Bldg 3
Surprise, AZ 85374

18747 N Reems Rd
Ste 500
Surprise, AZ 85374
Phone (520) 333-4949

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1881240760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18747 N REEMS RD STE 500",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748645",
            "telephone_number": "877-396-5133",
            "fax_number": "520-526-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18747 N REEMS RD STE 500",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748645",
            "telephone_number": "877-396-5133",
            "fax_number": "520-526-9962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 W Continental Rd Ste 216B",
            "address_purpose": "LOCATION",
            "city": "Green Valley",
            "state": "AZ",
            "postal_code": "856223596",
            "country_code": "US",
            "telephone_number": "520-333-4949",
            "fax_number": "520-526-9962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POOL OF BETHESDA PSYCHIATRIC HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "520-333-4949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, ARNP. PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@pobpsychiatry.com",
            "affiliation": "N",
            "address_1": "210 W Continental Rd Ste 216B",
            "city": "Green Valley",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "856223596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.