Individual provider Active NPI

Gina Linn Athetis, FNP-C

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1144403429
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN077817 Issued in AZ
Practice address
15425 N Greenway Hayden Loop
Suite A300
Scottsdale, AZ 85260-1204
Phone
(480) 607-1124
Fax
(480) 607-1087
NPI assigned
Dec 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN077817 AZ Primary

Addresses

Primary practice location

15425 N Greenway Hayden Loop
Suite A300
Scottsdale, AZ 85260-1204

Mailing address

4350 N 19TH Ave
Suite 6
Phoenix, AZ 85015-4602
Phone (480) 607-1124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1144403429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 N 19TH AVE",
            "address_2": "SUITE 6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154602",
            "telephone_number": "480-607-1124",
            "fax_number": "480-607-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15425 N GREENWAY HAYDEN LOOP",
            "address_2": "SUITE A300",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601204",
            "telephone_number": "480-607-1124",
            "fax_number": "480-607-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHETIS",
        "first_name": "GINA",
        "middle_name": "LINN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN077817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.