Individual provider Active NPI

Nicole Read, NP-C

  • Family Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1093178402
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
304670 Issued in AZ
Practice address
20713 E Ocotillo Rd Ste 100
Queen Creek, AZ 85142-6117
Phone
(480) 882-9993
Fax
(480) 248-2377
NPI assigned
Apr 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 304670 AZ Primary
Family Nurse Practitioner 363LF0000X 201707760NP-PP OR
Family Nurse Practitioner 363LF0000X APRN 2097 HI

Addresses

Primary practice location

20713 E Ocotillo Rd Ste 100
Queen Creek, AZ 85142-6117

Mailing address

20713 E Ocotillo Rd Ste 100
Queen Creek, AZ 85142-6117
Phone (480) 882-9993

Other identifiers 2

IdentifierTypeStateIssuer
500737603MedicaidAZ
500737603MedicaidOR

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
I20240723004424 AZ Practitioner - Nurse Practitioner 3971862889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Hawaii John a. Burns School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Medical Management LLCGroup PAC ID 4789947003, 3 clinicians

Practice addresses (Care Compare)

20713 E Ocotillo Rd
Suite 100
Queen Creek, AZ 85142-6117
Phone 4808829993101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN 2097HIMDFamily Nurse Practitioner
201707760NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Clinic, PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDAJCA/Endpoint/GDAJCA

Organizations & group practices 2

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": "1459555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1093178402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20713 E OCOTILLO RD STE 100",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426117",
            "telephone_number": "480-882-9993",
            "fax_number": "480-248-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20713 E OCOTILLO RD STE 100",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426117",
            "telephone_number": "480-882-9993",
            "fax_number": "480-248-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "READ",
        "first_name": "NICOLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-02",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "304670",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201707760NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN 2097",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500737603",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500737603",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.