Individual provider Active NPI

Kirsten Dominique Hart Rentfrow, FNP

  • Pediatric Nurse Practitioner
  • Green Valley, AZ
National Provider Identifier
1134523624
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP7353 Issued in AZ
Practice address
1260 S Campbell Ave
Green Valley, AZ 85614-0504
Phone
(520) 407-5600
Fax
(520) 407-5990
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP7353 AZ Primary

Addresses

Primary practice location

1260 S Campbell Ave
Green Valley, AZ 85614-0504

Mailing address

1260 S Campbell Ave
Green Valley, AZ 85614-0504
Phone (520) 407-5600

Other identifiers 1

IdentifierTypeStateIssuer
985949MedicaidAZ

Other names 1

  • Kirsten Dominique Hart Former 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
I20150207000455 AZ Practitioner - Nurse Practitioner 8527383801 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP7353AZMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Community Health Center - Maria Auxiliadora, Inc. Current Accepting new patients
United Community Health Center - Maria Auxiliadora Inc. CurrentSince Jul 1, 2020 Accepting new patients
Northwest Allied Physicians LLC CurrentSince Jul 1, 2019 Accepting new patients
Northwest Allied Physicians, LLC CurrentSince Jul 1, 2019 Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. CurrentSince Jul 1, 2020 Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. Past Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. Past Accepting new patients
Dean Ettinger MD, PC Past Accepting new patients
Marana Health Center, Inc Past Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. PastSince Sep 1, 2024 Accepting new patients

Locations

1260 S Campbell Ave
Green Valley, AZ 85614
Phone (520) 407-5600

1260 S Campbell Ave
Bldg 2
Green Valley, AZ 85614
Phone (520) 407-5400

13395 N Marana Main St
Marana, AZ 85653
Phone (520) 616-6200

18857 S La Canada Dr
Sahuarita, AZ 85629
Phone (520) 407-5800

3690 S Park Ave
Ste 805
Tucson, AZ 85713
Phone (520) 616-1560

8333 N Silverbell Rd
Ste 161
Tucson, AZ 85743
Phone (520) 202-7770

3870 W River Rd
Ste 126
Tucson, AZ 85741
Phone (520) 209-7000

13299 E Colossal Cave Rd
Vail, AZ 85641
Phone (520) 407-5606

Interoperability endpoints

  • Direct secure messaging: kirsten.rentfrow@uchc.eclinicaldirectplus.com

Organizations & group practices 10

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": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1134523624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 S CAMPBELL AVE",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140504",
            "telephone_number": "520-407-5600",
            "fax_number": "520-407-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 S CAMPBELL AVE",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140504",
            "telephone_number": "520-407-5600",
            "fax_number": "520-407-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTFROW",
        "first_name": "KIRSTEN",
        "middle_name": "DOMINIQUE HART",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP7353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "985949",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "HART",
            "middle_name": "DOMINIQUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Valley, AZ

Sources for this page

Verify at the official NPI Registry.