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DESERT BOLT BEHAVIORAL LLC
NPI 1649897414
Clinic/Center - Mental Health (Including Community Mental Health Center) in Anthem, AZ

Active since June 28, 2020
42201 N 41ST DR STE 160, ANTHEM, AZ 85086(850) 527-0042(480) 296-0002 Get Directions Write a Review

NPPES record last updated: July 5, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 5, 2021, Oct 6, 2020, Jun 28, 2020 (3 updates tracked since 2020).

About Desert Bolt Behavioral Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DESERT BOLT BEHAVIORAL LLC (NPI 1649897414) is a healthcare organization registered as a mental health (including community mental health center) in Anthem, Arizona and active in the NPI registry since June 2020. The organization lists Valery A Nkendong, Ceo, as its authorized official.

NPPES Registry Identity

NPI1649897414
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameDESERT BOLT BEHAVIORAL LLC
Location Address42201 N 41ST DR STE 160Anthem, AZ 85086-3803
Mailing Address42201 N 41st Dr Ste 160Anthem, AZ 85086-3803 · (850) 527-0042 · Fax (480) 296-0002
Phone(850) 527-0042
Fax(480) 296-0002
Organization SubpartNo
Authorized OfficialValery A NkendongCeo · (480) 527-0042
Enumeration DateJune 28, 2020
Last NPPES UpdateJuly 5, 20213 updates tracked since enumeration
NPPES CertifiedJuly 5, 2021
✔ NPI 1649897414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
42201 N 41ST DR STE 160, Anthem, AZ 85086
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Other Names 1

Former Legal Business NameDesert Bolt Behavioral Llc

Other Identifiers 1

Medicaid120200727001036AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna HealthCare of Arizona, Inc.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Desert Bolt Behavioral Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Desert Bolt Behavioral LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Hannah Parrish, PMHNP-BC
Nurse Practitioner
NPI 1053027250
42201 N 41ST DR STE 160
Anthem, AZ 85086
(480) 360-8112
✔ PECOS✔ Accepts MedicareSame address
Valery Nkendong, DNP, APRN, PMHNP-BC
Nurse Practitioner
NPI 1336763218
42201 N 41ST DR STE 160
Anthem, AZ 85086
(480) 527-0042
✔ PECOS✔ Accepts MedicareSame address
Ray Hamilton, DNP, PMHNP-BC, FNP-C
Nurse Practitioner
NPI 1184198475
28901 N 114TH ST
Scottsdale, AZ 85262
(480) 585-2595
✔ PECOS✔ Accepts Medicare20 mi
Michael Bass, PMHNP
Nurse Practitioner
NPI 1235829201
1840 N 95TH AVE STE 132
Phoenix, AZ 85037
(623) 932-6950
✔ PECOS✔ Accepts Medicare28 mi
Jennifer Whelan, BSN
Nurse Practitioner
NPI 1669236584
4270 N 81ST ST
Scottsdale, AZ 85251
(602) 549-7757
✔ PECOS✔ Accepts Medicare29 mi
Grace Ezenwaka, PMHNP
Nurse Practitioner
NPI 1023906997
250 S TOOLE AVE STE B
Tucson, AZ 85701
(520) 617-5500
✔ PECOS✔ Accepts Medicare133 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Desert Bolt Behavioral LLC's NPI number?

The NPI number for Desert Bolt Behavioral LLC is 1649897414. It was assigned to this organization in the NPPES registry on June 28, 2020.

Where is Desert Bolt Behavioral LLC located?

Desert Bolt Behavioral LLC is located at 42201 N 41st Dr Ste 160, Anthem, AZ 85086. The listed phone number is (850) 527-0042.

What is Desert Bolt Behavioral LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Desert Bolt Behavioral LLC enrolled in Medicare?

Yes. Desert Bolt Behavioral LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Desert Bolt Behavioral LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Desert Bolt Behavioral LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Desert Bolt Behavioral LLC accept?

Health plans from Cigna HealthCare of Arizona, Inc list Desert Bolt Behavioral LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Desert Bolt Behavioral LLC was last updated on July 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.