East Valley Joint Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP5244 Issued in AZ

Legal business name

EAST VALLEY JOINT CLINIC LLC

Practice address

3930 S Alma School Rd Ste 10
Chandler, AZ 85248-4510

Phone

(480) 718-1444

Fax

(480) 718-7729

NPI assigned

Oct 2, 2015

Organization subpart

No

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

Authorized official

Name

Joost Berkhout

Title

Managing Member

Phone

(480) 718-1444

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Divine IV and Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12882/brand/1/csg/1/fhir/r4

Practitioners 2

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

• Amy Berkhout, FNP-BC

  • Family Nurse Practitioner
  • Chandler, AZ
  • NPI 1609132505
  Medicare reassignment NPD
• Heather L Kashmer

  • Nurse Practitioner
  • Chandler, AZ
  • NPI 1841017613
  NPD (past)

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1952771024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 S ALMA SCHOOL RD STE 10",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852484510",
            "telephone_number": "480-718-1444",
            "fax_number": "480-718-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 S ALMA SCHOOL RD STE 10",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852484510",
            "telephone_number": "480-718-1444",
            "fax_number": "480-718-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY JOINT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-02",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "BERKHOUT",
        "authorized_official_first_name": "JOOST",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "480-718-1444"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100091",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine IV and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• East Valley Family Physicians PLC
• East Valley Gastroenterology and Hepatology PC
• East Valley Hematologists and Oncologists
• East Valley Hospital, LLC
• East Valley Internal Medicine PC
• East Valley Medical Associates, PLC
• East Valley Medical Associates, PLC
• East Valley Medicine PLC
• East Valley Oral Surgery,PC
• East Valley Pcit, PLLC

• Family Nurse Practitioner in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.