Organization Active NPI

Pottermind Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1952280687
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
POTTERMIND PSYCHIATRY
Practice address
908 W Chandler Blvd Ste B-3
Chandler, AZ 85225-2549
Phone
(480) 432-4237
NPI assigned
Aug 27, 2025
Last updated
Feb 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Taiwo Ajayi
Title
Managing Director
Phone
(480) 235-1582

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

908 W Chandler Blvd Ste B-3
Chandler, AZ 85225-2549

Mailing address

908 W Chandler Blvd Ste B-3
Chandler, AZ 85225-2549
Phone (480) 432-4237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251210002304 AZ Part B Supplier - Clinic/Group Practice 0648764340 Receives reassigned benefits from 1 practitioner
Practice locations: Chandler, AZ

National Provider Directory

National Provider Directory

Locations

908 W Chandler Blvd
Ste B-3
Chandler, AZ 85225
Phone (480) 899-5962

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1952280687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 W CHANDLER BLVD STE B-3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252549",
            "telephone_number": "480-432-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 W CHANDLER BLVD STE B-3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252549",
            "telephone_number": "480-432-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTERMIND PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "AJAYI",
        "authorized_official_first_name": "TAIWO",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "480-235-1582"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.