Phoenix Behavioral Group LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PHOENIX BEHAVIORAL GROUP LLC

Practice address

4949 Tamiami TRL N Ste 202
Naples, FL 34103-3017

Phone

(239) 259-1659

Fax

(239) 692-8264

NPI assigned

Dec 8, 2023

Organization subpart

No

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

Authorized official

Name

Johanny Ortiz, PMHNP-BCNPI 1154027746

Title

MBR

Phone

(239) 276-9464

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Johanny Ortiz

  • Psychiatric/Mental Health Nurse Practitioner
  • Naples, FL
  • NPI 1154027746
  Medicare reassignment NPD Authorized official
• Anna Maria Orshowitz, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Naples, FL
  • NPI 1518817451

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1902673031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 TAMIAMI TRL N STE 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033017",
            "telephone_number": "239-259-1659",
            "fax_number": "239-692-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 TAMIAMI TRL N STE 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033017",
            "telephone_number": "239-259-1659",
            "fax_number": "239-692-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX BEHAVIORAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "JOHANNY",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "239-276-9464",
        "authorized_official_credential": "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": [],
    "other_names": []
}

• Melissa Fern Phillips
• Raymond W Phillips, M.D.
• Philmed Health Services LLC
• Jacqueline Phimmasone, MSW
• Phoebe C. Houghton LCSW LLC
• Physiatry Florida LLC
• Physical Therapy Center of Naples, LLC (Physical Therapy Center Of Naples)
• Physical Therapy Clinic of Naples LLC
• Physician Led Access Network (Plan) of Collier County
• Physician's Managed Services Organization of Southwest Florida, LLC (Total Woman's Care)

• Psychiatric/Mental Health Nurse Practitioner in Naples, FL
• Providers in Naples, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.