Marilyn Ann Staires

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP3646 Issued in AZ

Practice address

18614 W Onyx Ave
Waddell, AZ 85355-4448

Phone

(480) 467-8665

NPI assigned

Feb 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Free Life Wellness Center LLC

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1316539687
  Medicare reassignment NPD
• Equity Behavioral Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1992451744
  NPD Authorized official
• Peace of Mind Behavioral Health LLC

  dba Peace of Mind Wellness Center

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1215607957
  NPD

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

{
    "created_epoch": "1266710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1962724799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 E MARK LN",
            "city": "CAVE CREEK",
            "state": "AZ",
            "postal_code": "853313392",
            "telephone_number": "480-467-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18614 W ONYX AVE",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853554448",
            "telephone_number": "480-467-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAIRES",
        "first_name": "MARILYN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-21",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN106359",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP3646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Madison Rozelle, ATC, LAT
• Saloni Mental Health
• Florencia Seguezza
• Seneca Rock Behavioral Health LLC
• Joanne Lynn Solari, LCSW
• Merisa Stefaniak
• Yolanda Stephensjohnson
• Ester S Stevens, PSYD
• Kim L Swanson
• The Resilient Life Integrative Health Center LLC

• Psychiatric/Mental Health Nurse Practitioner in Waddell, AZ
• Providers in Waddell, 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 Apr 19, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.