Individual provider Active NPI

Waneta Johanna Carter, SNP-C

  • Adult Health Nurse Practitioner
  • Sun City, AZ
National Provider Identifier
1144966086
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
274297 Issued in AZ
Practice address
12630 N 103Rd Ave Ste 142
Sun City, AZ 85351-3463
Phone
(480) 275-2022
NPI assigned
May 12, 2022
Last updated
May 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 274297 AZ Primary

Addresses

Primary practice location

12630 N 103Rd Ave Ste 142
Sun City, AZ 85351-3463

Mailing address

2632 S 83Rd Ave # 100-259
Phoenix, AZ 85043-7206
Phone (623) 810-4270

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
I20220720003260 AZ Practitioner - Nurse Practitioner 6709267883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Az at Home IncGroup PAC ID 9830406388, 4 clinicians

Practice addresses (Care Compare)

12630 N 103Rd Ave
Suite 142
Sun City, AZ 85351-3463
Phone (480) 275-2022

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
56 of 100Reported as group
Quality
45
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274297AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Az at Home Inc Single Specialty CurrentSince Mar 1, 2023 Accepting new patients

Locations

12630 N 103rd Ave
Ste 142
Sun City, AZ 85351
Phone (480) 275-2022

Interoperability endpoints

  • Direct secure messaging: waneta.carter@15563556519940.direct.elationemr.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1144966086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 S 83RD AVE # 100-259",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850437206",
            "telephone_number": "623-810-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 N 103RD AVE STE 142",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513463",
            "telephone_number": "480-275-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "WANETA",
        "middle_name": "JOHANNA",
        "name_prefix": "Ms.",
        "credential": "SNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "274297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.