Individual provider Active NPI

Kia Lambeth

  • Nurse Practitioner
  • Avondale, AZ
National Provider Identifier
1033622295
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP10679 Issued in AZ
Practice address
10815 W McDowell Rd Ste 305
Avondale, AZ 85392-5016
Phone
(623) 936-3312
Fax
(623) 936-4248
NPI assigned
Nov 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP10679 AZ Primary

Addresses

Primary practice location

10815 W McDowell Rd Ste 305
Avondale, AZ 85392-5016

Mailing address

3815 E Bell Rd Ste 4500
Phoenix, AZ 85032-2171
Phone (602) 633-3848

Other identifiers 2

IdentifierTypeStateIssuer
Z209239OtherAZMEDICARE
331053MedicaidAZ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171219002072 AZ Practitioner - Nurse Practitioner 4486912599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Arizona, LLCGroup PAC ID 1052328408, 94 clinicians

Practice addresses (Care Compare)

10815 W McDowell Rd
Suite 205
Avondale, AZ 85392-5010
Phone (623) 433-0202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP10679AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Arizona, LLC Current Accepting new patients
Privia Medical Group Arizona, LLC CurrentSince Feb 1, 2018 Accepting new patients
Privia Medical Group Arizona, LLC CurrentSince Feb 1, 2018 Accepting new patients

Locations

10815 W McDowell Rd
Ste 3
Avondale, AZ 85392

10815 W McDowell Rd
Ste 304
Avondale, AZ 85392
Phone (623) 433-0155

10815 W McDowell Rd
Ste 305
Avondale, AZ 85392
Phone (480) 840-1754

10815 W McDowell Rd
Ste 205
Avondale, AZ 85392
Phone (623) 848-3295

10815 W McDowell Rd
Ste 201
Avondale, AZ 85392
Phone (623) 433-0230

13555 W McDowell Rd
Ste 101
Goodyear, AZ 85395
Phone (623) 935-4700

14415 W McDowell Rd
Ste D102
Goodyear, AZ 85395
Phone (623) 512-4190

111 W Cedar Ln
Ste A
Payson, AZ 85541
Phone (928) 472-4675

1301 S 7th Ave
Ste 400
Phoenix, AZ 85007
Phone (602) 824-3358

3815 E Bell Rd
Ste 4500
Phoenix, AZ 85032
Phone (602) 633-3838

9250 N 3rd St
Ste 4010
Phoenix, AZ 85020
Phone (602) 633-3838

3815 E Bell Rd
Ste 3200
Phoenix, AZ 85032
Phone (480) 840-1754

Interoperability endpoints

  • Direct secure messaging: kia.lambeth.2@33227.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1033622295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 4500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322171",
            "telephone_number": "602-633-3848",
            "fax_number": "602-633-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 W MCDOWELL RD STE 305",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925016",
            "telephone_number": "623-936-3312",
            "fax_number": "623-936-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBETH",
        "first_name": "KIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP10679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z209239",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331053",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.