DESERT SANDS MEDICAL GROUP (NPI# 1649802828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649802828 |
| Entity Type | Organization |
| Organization Name | DESERT SANDS MEDICAL GROUP |
| Practice Address |
34406 N 27th Dr Ste 140 Phoenix AZ 85085-6079 |
| Practice Telephone | 4806485217 |
| Practice Fax Number | 6233212352 |
| Mailing Telephone | 4806485217 |
| Mailing Fax Number | 6233212352 |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |
| Authorized Official Name | STEPHANIE A BRADY (OWNER) |
| Authorized Official Telephone | 4806485217 |
| Authorized Official Credential | PMHNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| DESERT SANDS MEDICAL GROUP | Doing Business As Name - Organization |
| Street Address |
34406 N 27TH DR STE 140 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85085-6079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730447244 | Stephanie Ann Brady | Nurse Practitioner | 34406 N 27th Dr Ste 140, Phoenix, AZ 85085-6079 | 2012-05-03 |
| 1407468630 | Matthew Dwight | Marriage & Family Therapist | 34406 N 27th Dr Ste 140, Phoenix, AZ 85085-6079 | 2020-08-19 |
| 1255968038 | Andrea Fry | Counselor | 34406 N 27th Dr Ste 140, Phoenix, AZ 85085-6079 | 2020-03-24 |
| 1215582697 | Kaleigh Rhodes | Social Worker | 34406 N 27th Dr Ste 140, Phoenix, AZ 85085-6079 | 2019-08-02 |
| 1306333133 | Alan P Ketterling | Marriage & Family Therapist | 34406 N 27th Dr Ste 140, Phoenix, AZ 85085-6079 | 2018-04-17 |
| 1891209961 | Dantia Wellness LLC | Marriage & Family Therapist | 34406 N 27th Dr Ste 140, Phoenix, AZ 85085-6079 | 2017-11-27 |
| 1700390135 | Nicole Renee Doyle | Social Worker | 34406 N 27th Dr Ste 140, Phoenix, AZ 85085-6079 | 2017-11-21 |
| 1023540531 | Brentom, LLC | Occupational Therapist | 34406 N 27th Dr Ste 140, Phoenix, AZ 85085 | 2017-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235748369 | Nicole Fountain | Speech-Language Pathologist | 25700 N. 21st Avenue, Phoenix, AZ 85085 | 2020-07-24 |
| 1083138010 | Larry Leforte II | Emergency Medical Technician, Paramedic | 2018 W Blaylock Dr, Phoenix, AZ 85085 | 2017-08-01 |
| 1508318809 | Jennifer Falk | Chiropractor | 1614 W Whispering Wind Dr Ste 3, Phoenix, AZ 85085 | 2016-11-03 |
| 1053785964 | Cvs Pharmacy | Pharmacy | 28635 N North Vally Parkway, Phoenix, AZ 85085 | 2015-11-17 |
| 1417329897 | Kelly Criswell | Registered Nurse | 32150 N North Foothills Dr, Phoenix, AZ 85085 | 2015-10-26 |
| 1417333717 | Kristi Everett | Social Worker | 34225 N 27th Dr Bldg 5 Ste 146, Phoenix, AZ 85085 | 2015-08-10 |
| 1063849834 | Albertsons Pharmacy | Pharmacist | 2406 W Bramble Berry Ln, Phoenix, AZ 85085 | 2013-10-10 |
| 1427354851 | Carolyn Berg Newsome | Marriage & Family Therapist | 2060 W.whispering Wind Drive, Phoenix, AZ 85085 | 2011-02-02 |
| 1518273127 | Jamie Lynn Born | Social Worker | 34406 N 27th Dr Bldg 6, Phoenix, AZ 85085 | 2010-08-20 |
| 1023347218 | Lise Flores-reed | Psychologist | 34225 N. 27th Drive #110, Phoenix, AZ 85085 | 2009-12-17 |
| Find all providers in zip 85085 | ||||
| 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 |
|---|---|---|---|---|
| 1215536479 | Yolanda D Baugh | Nurse Practitioner | 2625 W Piedmont Rd, Phoenix, AZ 85041-9540 | 2020-10-20 |
| 1306450960 | Williamsconsultant Com LLC | Nurse Practitioner | 2303 N 44th St Ste 12-1043, Phoenix, AZ 85008-2442 | 2020-09-01 |
| 1912515305 | Victory Health Solution LLC | Nurse Practitioner | 9132 W Hubbell St, Phoenix, AZ 85037-4377 | 2020-07-21 |
| 1700494374 | Vanessa Moe | Nurse Practitioner | 42949 N Voyage Trl, Phoenix, AZ 85086-8040 | 2020-07-20 |
| 1043838527 | Latasha Lynne Freeman | Nurse Practitioner | 1919 E Thomas Rd Bldg 5th, Phoenix, AZ 85016-7710 | 2020-07-10 |
| 1861019416 | Gayle Cecilia Bachelier | Nurse Practitioner | 2302 N Central Ave Unit 303, Phoenix, AZ 85004-1373 | 2020-06-30 |
| 1871119156 | Ashlyn Tellers | Nurse Practitioner | 21438 N 33rd Ave, Phoenix, AZ 85027-2241 | 2020-06-22 |
| 1770109605 | Hannah Carita Jurekovic-byrd | Nurse Practitioner | 5727 N 7th St Ste 308, Phoenix, AZ 85014-5817 | 2020-06-16 |
| 1578188025 | Joseph Medlin | Nurse Practitioner | 915 N 52nd St Apt 2010, Phoenix, AZ 85008-7934 | 2020-06-10 |
| 1750901088 | Foothills Psychiatric Services Pllc | Nurse Practitioner | 3546 E Windmere Dr, Phoenix, AZ 85048-7211 | 2020-04-16 |
| Find all providers in PHOENIX | ||||
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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.