Cmr2612,LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

CMR2612,LLC

Doing business as

CMR Wound Housecall

Practice address

24 W Camelback Rd Ste a
Phoenix, AZ 85013-2529

Phone

(623) 377-2747

Fax

(602) 581-3016

NPI assigned

Jan 6, 2025

Organization subpart

No

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

Authorized official

Name

Carlos Rivera, FNP-BC

Title

Provider

Phone

(623) 377-2747

Specialties & licenses 1

Addresses

Other names 2

• CMR WOUND HOUSECALL Doing business as
• CARLOS RIVERA Other name

Locations

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1063221836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 W CAMELBACK RD STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850132529",
            "telephone_number": "623-377-2747",
            "fax_number": "602-581-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 W CAMELBACK RD STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850132529",
            "telephone_number": "623-377-2747",
            "fax_number": "602-581-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMR2612,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "623-377-2747",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMR WOUND HOUSECALL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CARLOS RIVERA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, 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 Jan 6, 2025; 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.