BRYAN REDDICK (DNP, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1215744651

BRYAN REDDICK (DNP, PMHNP-BC) is a healthcare provider. based in Phoenix, Arizona. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP, PMHNP-BC. They hold a License No. 316538 (AZ). The NPI Number for BRYAN REDDICK (DNP, PMHNP-BC) is 1215744651

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
BRYAN REDDICK (DNP, PMHNP-BC)
NPI
1215744651
Phone
(952) 221-9581
Address
4417 E SAINT CATHERINE AVE
Enumeration Date
18 December 2024
Last Update Date
18 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6232330914
Graduation Year
2024 (2 years ago)
PAC ID
0143759084
Group Practice PAC ID
0840669800
Professional Enrollment ID
I20250313004008
Address ID
CO802114240DE2855XBLVD402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

7,509 NURSE PRACTITIONER in AZ

Provider Addresses for BRYAN REDDICK (DNP, PMHNP-BC)

  • 4417 E SAINT CATHERINE AVE

    PHOENIX, AZ 850425363

    Phone: (952) 221-9581

    Type: Mailing

  • 7301 N 16TH ST STE 102

    PHOENIX, AZ 850205266

    Phone: (623) 294-2007

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250122002807INurse PractitionerAZTBD
I20250313004008INurse PractitionerCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 85042)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840669800View full group profile
NameSpecialtyState
Nurse PractitionerAZ
Nurse PractitionerCO
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerUT
Nurse PractitionerTX

Reviews

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Frequently asked questions

What identifier follows BRYAN REDDICK (DNP, PMHNP-BC) across health systems?
The NPI 1215744651 uniquely identifies BRYAN REDDICK (DNP, PMHNP-BC) in U.S. healthcare data.
Should I treat BRYAN REDDICK (DNP, PMHNP-BC) as an active provider?
Patients and plans typically see BRYAN REDDICK (DNP, PMHNP-BC) as active in the national extract.
What services align with BRYAN REDDICK (DNP, PMHNP-BC)'s listing?
BRYAN REDDICK (DNP, PMHNP-BC)'s public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to BRYAN REDDICK (DNP, PMHNP-BC)?
BRYAN REDDICK (DNP, PMHNP-BC) shows a connection to Phoenix, Arizona in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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