Gary Michael Rayburn, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

270751 Issued in AZ

Practice address

4374 E Butte Ave
Florence, AZ 85132

Phone

(520) 868-0201

NPI assigned

Feb 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1043965502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 W EMELITA AVE APT 2104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852023168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4374 E BUTTE AVE",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "85132",
            "telephone_number": "520-868-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "GARY",
        "middle_name": "MICHAEL",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "270751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pondeca Consultants (Thrive Place Behavioral)
• Clara Pondeca
• Prince of Peace Hospice & Palliative Care
• Lindsay Catherine Radcliffe
• Ranchester Springs LLC (Freedom Sports and Physical Therapy)
• Rosalyn Leander Reed, LPN
• Reid House LLC
• Rite Therapy Solutions PLLC
• Jan Marie Roberson, L.P.N.
• Phyl K Robinson, MFT

• Family Nurse Practitioner in Florence, AZ
• Providers in Florence, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.