Beth Pembroke

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

271416 Issued in AZ

Practice address

16620 N 40TH St Ste E-1
Phoenix, AZ 85032-3348

Phone

(602) 464-9576

Fax

(602) 626-8901

NPI assigned

Jan 29, 2018

Last updated

Jul 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, CO, NY, NM4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 4

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  AZ, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Little Colorado Behavioral Health Center Inc.

  • Community/Behavioral Health Agency
  • Saint Johns, AZ
  • NPI 1134292485
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, CO, NM, NY, Psychiatric/Mental Health

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  CO

  Medicare reassignment NPD
• Little Colorado Behavioral Health Center Inc.

  • Community/Behavioral Health Agency
  • Springerville, AZ
  • NPI 1194872085
  NPD
• Little Colorado Behavioral Health Center Inc.

  dba SMI Supportive Housing - Apache

  • Community/Behavioral Health Agency
  • Saint Johns, AZ
  • NPI 1588543029
  NPD

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1902304678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 N 16TH ST STE 114",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165344",
            "telephone_number": "602-464-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST STE E-1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323348",
            "telephone_number": "602-464-9576",
            "fax_number": "602-626-8901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2304 N Rosemont Blvd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122139",
            "country_code": "US",
            "telephone_number": "520-867-4960",
            "fax_number": "520-867-9550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7914 E Sabino Sunrise Cir",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857509751",
            "country_code": "US",
            "telephone_number": "904-412-6291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36457 N Gantzel Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "San Tan Valley",
            "state": "AZ",
            "postal_code": "851407343",
            "country_code": "US",
            "telephone_number": "480-764-1900",
            "fax_number": "480-764-1902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 W Orange Grove Rd Ste 414",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857041141",
            "country_code": "US",
            "telephone_number": "520-534-2000",
            "fax_number": "520-534-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEMBROKE",
        "first_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "13987096-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0102379-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "79497",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405679-01",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "271416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Kate Pellizzon, MS RD
• Katelyn Wentworth Peltier, PHARMD
• Christopher Peluso, PMHNP-BC
• Christine Rose Pemberton, LPC
• Faith Pembleton, CRNA
• Amie Pena, NP
• Christien Pena, MD
• Danae Marie Pena, PTA
• Dennis Rey Pena, D.P.M.
• Irma Pena

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.