Individual provider Active NPI

Dekozlymn Anderson, CRNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1134556061
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-106321 Issued in AL
Practice address
9515 W Camelback Rd Ste 136&138
Phoenix, AZ 85037-1355
Phone
(850) 304-7986
NPI assigned
Oct 10, 2013
Last updated
Feb 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024180539 VA
Family Nurse Practitioner 363LF0000X 229161 LA
Family Nurse Practitioner 363LF0000X 1018365 TX
Family Nurse Practitioner 363LF0000X 1-106321 AL Primary
Family Nurse Practitioner 363LF0000X 281866 AZ
Family Nurse Practitioner 363LF0000X GAA-NP000112 GA
Family Nurse Practitioner 363LF0000X TPAN1658 FL
Family Nurse Practitioner 363LF0000X 26670 SC

Addresses

Primary practice location

9515 W Camelback Rd Ste 136&138
Phoenix, AZ 85037-1355

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (850) 304-7986

Other practice location 1

7525 Tidewater Dr Ste 19
Norfolk, VA 23505-3700
Phone (850) 304-7986

Other practice location 2

545 Gulfgate Center Mall
Houston, TX 77087-3023
Phone (850) 304-7986

Other practice location 3

1821 Mount Zion Rd
Morrow, GA 30260-3015
Phone (850) 304-7986

Other practice location 4

941 N 14th St
Leesburg, FL 34748-3838
Phone (850) 304-7986

Other practice location 5

7551 Youree Dr Ste 11
Shreveport, LA 71105-5533
Phone (850) 304-7986

Other practice location 6

2001 E Greenville St
Anderson, SC 29621-1529
Phone (850) 304-7986

Electronic endpoints 7

TypeEndpointUseAffiliation
Direct Messaging Address dekozlymn.anderson.5@29601.direct.athenahealth.com Direct
Direct Messaging Address dekozlymn.anderson.1@29601.direct.athenahealth.com Direct
Direct Messaging Address dekozlymn.anderson.7@29601.direct.athenahealth.com Direct
Direct Messaging Address dekozlymn.anderson.6@29601.direct.athenahealth.com Direct
Direct Messaging Address dekozlymn.anderson.3@29601.direct.athenahealth.com Direct
Direct Messaging Address dekozlymn.anderson.4@29601.direct.athenahealth.com Direct
Direct Messaging Address dekozlymn.anderson.2@29601.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, VA, TX, LA, TN, SC, GA7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20231002000468 AZ Practitioner - Nurse Practitioner 0446471031 Reassigns benefits to 1 organization
I20240613001048 VA Practitioner - Nurse Practitioner 0446471031 Reassigns benefits to 1 organization
I20250818002227 TX Practitioner - Nurse Practitioner 0446471031 Reassigns benefits to 3 organizations
I20251111001744 LA Practitioner - Nurse Practitioner 0446471031 Reassigns benefits to 2 organizations
I20251111003646 TN Practitioner - Nurse Practitioner 0446471031 Reassigns benefits to 1 organization
I20260212004551 SC Practitioner - Nurse Practitioner 0446471031 Reassigns benefits to 1 organization
I20260219004640 GA Practitioner - Nurse Practitioner 0446471031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2261 Market St
San Francisco, CA 94114-1612

5995 Waterside Dr
Hoover, AL 35244-4193

6101 Blue Lagoon Dr
Suite 200
Miami, FL 33126

6101 Blue Lagoon Dr
Suite 200
Miami, FL 33126-3168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
32545TNMDRegistered Nurse
1-106321ALMDFamily Nurse Practitioner
281866AZMDFamily Nurse Practitioner
TPAN1658FLMDFamily Nurse Practitioner
GAA-NP000112GAMDFamily Nurse Practitioner
229161LAMDFamily Nurse Practitioner
26670SCMDFamily Nurse Practitioner
1018365TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Physician Services of Texas, P.a. CurrentSince Aug 1, 2025 Accepting new patients
Centerwell Senior Primary Care Az CS PC CurrentSince Sep 1, 2025 Accepting new patients
Centerwell Senior Primary Care Az CS PC CurrentSince Sep 1, 2025 Accepting new patients
Ophelia Medical Group, P.C. CurrentSince Jun 24, 2024 Accepting new patients
Centerwell Senior Primary Care (SC) PC CurrentSince Jan 6, 2026 Accepting new patients
Centerwell Senior Primary Care Ga CS PC CurrentSince Jan 6, 2026 Accepting new patients
Centerwell Senior Primary Care TX CS PA CurrentSince Sep 1, 2025 Accepting new patients
Centerwell Senior Primary Care (SC) PC CurrentSince Jan 6, 2026 Accepting new patients
Centerwell Senior Primary Care la CS PC CurrentSince Sep 1, 2025 Accepting new patients
Centerwell Senior Primary Care TN CS PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

9515 W Camelback Rd
Ste 136
Phoenix, AZ 85037
Phone (623) 322-8906

9515 W Camelback Rd
Ste 136138
Phoenix, AZ 85037
Phone (623) 322-8906

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

1821 Mount Zion Rd
Morrow, GA 30260
Phone (470) 754-6380

7551 Youree Dr
Ste 11
Shreveport, LA 71105
Phone (318) 642-9282

2001 E Greenville St
Anderson, SC 29621
Phone (864) 332-3098

1947 Madison St
Ste B
Clarksville, TN 37043
Phone (931) 614-7169

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

545 Gulfgate Center Mall
Houston, TX 77087
Phone (281) 846-7209

Interoperability endpoints

  • Direct secure messaging: dekozlymn.anderson.5@29601.direct.athenahealth.com
  • Direct secure messaging: dekozlymn.anderson.7@29601.direct.athenahealth.com
  • Direct secure messaging: dvanderson@direct.uabmedicine.org

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1134556061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "850-304-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 W CAMELBACK RD STE 136&138",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371355",
            "telephone_number": "850-304-7986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7525 Tidewater Dr Ste 19",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235053700",
            "country_code": "US",
            "telephone_number": "850-304-7986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 Gulfgate Center Mall",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770873023",
            "country_code": "US",
            "telephone_number": "850-304-7986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1821 Mount Zion Rd",
            "address_purpose": "LOCATION",
            "city": "Morrow",
            "state": "GA",
            "postal_code": "302603015",
            "country_code": "US",
            "telephone_number": "850-304-7986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "941 N 14th St",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347483838",
            "country_code": "US",
            "telephone_number": "850-304-7986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7551 Youree Dr Ste 11",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711055533",
            "country_code": "US",
            "telephone_number": "850-304-7986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 E Greenville St",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296211529",
            "country_code": "US",
            "telephone_number": "850-304-7986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DEKOZLYMN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-10",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180539",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "229161",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1018365",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-106321",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "281866",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP000112",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "TPAN1658",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "26670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dekozlymn.anderson.5@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7525 Tidewater Dr Ste 19",
            "city": "Norfolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "235053700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dekozlymn.anderson.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9515 W Camelback Rd Ste 136&138",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850371355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dekozlymn.anderson.7@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "545 Gulfgate Center Mall",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770873023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dekozlymn.anderson.6@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "941 N 14th St",
            "city": "Leesburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347483838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dekozlymn.anderson.3@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1821 Mount Zion Rd",
            "city": "Morrow",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302603015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dekozlymn.anderson.4@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7551 Youree Dr Ste 11",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711055533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dekozlymn.anderson.2@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2001 E Greenville St",
            "city": "Anderson",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296211529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.