Carmen Lervold, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

278253 Issued in AZ

Practice address

11022 S 51St St Ste 250
Phoenix, AZ 85044-4319

Phone

(480) 939-6137

NPI assigned

Jul 17, 2022

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Mountain Family Psychiatry LLCGroup PAC ID 7012346760, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carmen.lervold.1@21710.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/21710/brand/1/csg/1/fhir/r4

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.

• South Mountain Family Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
  • NPI 1336788868
  Medicare reassignment Care Compare group NPD
• Phoenix Family Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Avondale, AZ
  • NPI 1477447050
  NPD Authorized official

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

{
    "created_epoch": "1658016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1972238731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11022 S 51ST ST STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11022 S 51ST ST STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444319",
            "telephone_number": "480-939-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERVOLD",
        "first_name": "CARMEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-17",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "AZ",
            "license": "RN172593",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "278253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Lerdal, AGNP
• Krista N Lerner, DDS
• Amanda Sarah Lernor, D.P.M.
• Charlotte Leroux, BPHARM, PHD
• David Ralph Lersch, MD
• Michael Lesac, MD
• Kelli Lynn Lesage-Bank, PNP
• Katrina Ann Lescarbeau, LMSW
• Nicole Marie Leschak, RDN
• Stephen J. Leshin, M.D.

• 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 Aug 15, 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.
• 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.