Individual provider Active NPI

Nevin John Paul

  • Student in an Organized Health Care Education/Training Program
  • Phoenix, AZ
National Provider Identifier
1114896313
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
9250 N 3Rd St Ste 4010
Phoenix, AZ 85020-2432
Phone
(602) 997-7331
Fax
(602) 870-4512
NPI assigned
Nov 4, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

9250 N 3Rd St Ste 4010
Phoenix, AZ 85020-2432

Mailing address

9250 N 3Rd St Ste 4010
Phoenix, AZ 85020-2432
Phone (602) 997-7331

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260120001355 AZ Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 5395222525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1114896313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 N 3RD ST STE 4010",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202432",
            "telephone_number": "602-997-7331",
            "fax_number": "602-870-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 N 3RD ST STE 4010",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202432",
            "telephone_number": "602-997-7331",
            "fax_number": "602-870-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "NEVIN",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.