Individual provider Active NPI

Raina Mae Elpedes Feudo, NP

  • Family Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1043916497
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
285540 Issued in AZ
Practice address
2430 W Ray Rd Ste 3
Chandler, AZ 85224-3552
Phone
(480) 626-6318
NPI assigned
Feb 6, 2023
Last updated
Feb 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 285540 AZ Primary

Addresses

Primary practice location

2430 W Ray Rd Ste 3
Chandler, AZ 85224-3552

Mailing address

2430 W Ray Rd Ste 3
Chandler, AZ 85224-3552
Phone (480) 626-6318

Other practice location 1

1400 N Gilbert Rd Ste E-1
Gilbert, AZ 85234-2321
Phone (480) 398-2411

Other names 1

  • Raina Mae Feudo-Witkowski Other name

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
I20230421002325 AZ Practitioner - Nurse Practitioner 9335504547

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285540AZMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1043916497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 W RAY RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243552",
            "telephone_number": "480-626-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 W RAY RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243552",
            "telephone_number": "480-626-6318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 N Gilbert Rd Ste E-1",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852342321",
            "country_code": "US",
            "telephone_number": "480-398-2411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEUDO",
        "first_name": "RAINA MAE",
        "middle_name": "ELPEDES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "285540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAINA MAE",
            "last_name": "FEUDO-WITKOWSKI",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.