KIM ANDERSON GREENWOOD (NPI# 1417048356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417048356 |
Entity Type | Individual |
Full Name | KIM ANDERSON GREENWOOD |
Credential | PNP, MS |
Practice Address |
590 S Ocotillo Ave Benson AZ 85602-6405 |
Mailing Address |
489 N Arroyo Blvd Nogales AZ 85621-2644 |
Practice Telephone | 5205867080 |
Practice Fax Number | 5205863163 |
Mailing Telephone | 5202874713 |
Mailing Fax Number | 5202879794 |
Enumeration Date | 2006-09-27 |
Last Update Date | 2007-07-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
PNPAP0073 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | AHCCCS # | 488462 | 01 |
Street Address |
590 S OCOTILLO AVE |
City | BENSON |
State | AZ |
Zip Code | 85602-6405 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255329132 | Southeastern Arizona Behavioral Health Services, Inc. | Public Health or Welfare | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2005-10-13 |
1760830137 | Southeastern Arizona Behavioral Health Services, Inc. | Community/Behavioral Health | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2016-05-26 |
1790095313 | King Richard Randell | Counselor | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2010-10-15 |
1245544071 | Murray Ellis Leimsieder | Counselor | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2010-08-04 |
1902968845 | Jennie Elise Mcmillian | Counselor | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2006-12-15 |
1063505014 | Stacy L Paul | Counselor | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2006-10-02 |
1750328480 | Robin A. Toole | Social Worker | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2006-06-01 |
1275586117 | Ronald E. Basil | Social Worker | 590 S Ocotillo Ave, Benson, AZ 85602-6405 | 2006-05-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821582529 | Chiricahua Community Health Centers, Inc | Clinic/Center | 335 South Ocotillo Avenue, Benson, AZ 85602 | 2018-06-18 |
1437651288 | Chiricahua Community Health Centers Inc | Pharmacy | 335 S Ocotillo Avenue, Benson, AZ 85602 | 2018-03-07 |
1295191641 | Caring Connections for Special Needs, LLC. | Community/Behavioral Health | 870 W 4th St, Benson, AZ 85602 | 2016-01-14 |
1396158762 | Nicole Michelle Morris | Audiologist | 1989 S. Frontage Rd., Audiology Hearing and Balance Services, Sierra Vista, AZ 85602 | 2014-06-03 |
1467735217 | Josephine Anne Ellsworth | Counselor | 811 Maverick Lane, Benson, AZ 85602 | 2011-09-27 |
1730483819 | Charles Dean Kartchner | Anesthesiology | 1357 East Airport Road, Benson, AZ 85602 | 2011-01-04 |
1699077321 | Community Bridges, Inc | Clinic/Center | 470 S Ocotillo Ave # 2, Benson, AZ 85602 | 2010-12-01 |
1801106844 | Tomas G. Soto | Social Worker | 611 W. Union St., Benson, AZ 85602 | 2010-10-08 |
1982929451 | Marla Jeanne Trepanier | Pharmacist | 795 W Fourth Street, Benson, AZ 85602 | 2010-03-29 |
1396910832 | Susan May Boge | Occupational Therapist | 1764 N Ocotillo Rd, Benson, AZ 85602 | 2008-04-25 |
Find all providers in zip 85602 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396907598 | Sarah Manco | Nurse Practitioner | 611 W Union St, Benson, AZ 85602-6718 | 2008-06-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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1215536479 | Yolanda D Baugh | Nurse Practitioner | 2625 W Piedmont Rd, Phoenix, AZ 85041-9540 | 2020-10-20 |
1871191593 | Lisa E Legg | Nurse Practitioner | 1480 E Pecos Rd Apt 3107, Gilbert, AZ 85295-1851 | 2020-10-14 |
1619584406 | Preston Strebeck | Nurse Practitioner | 3733 E Meadow Mist Ln, San Tan Valley, AZ 85140-5374 | 2020-09-25 |
1336754332 | Yvonne Maese | Nurse Practitioner | 824 N 99th Ave Ste 107-108, Avondale, AZ 85323-5324 | 2020-09-15 |
1306450960 | Williamsconsultant Com LLC | Nurse Practitioner | 2303 N 44th St Ste 12-1043, Phoenix, AZ 85008-2442 | 2020-09-01 |
1215549274 | Maria Graciela Cornejo | Nurse Practitioner | 3421 S Loback Ln, Gilbert, AZ 85297-7913 | 2020-08-20 |
1013529155 | Mark Skousen | Nurse Practitioner | 1745 W Western Dove Dr, Snowflake, AZ 85937-6185 | 2020-08-19 |
1356953699 | Rebecca Jane Turley | Nurse Practitioner | 1681 S Villas Ln, Chandler, AZ 85286-6805 | 2020-08-18 |
1467064063 | Dylan O'keefe Carey | Nurse Practitioner | 11702 W Fordson Dr, Marana, AZ 85653-7715 | 2020-08-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.