Active NPI
Linda Mary Paullin, ANP
- Adult Health Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1154388346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- RN065843
- Practice address
- 3003 N Central Ave
Suite 800
Phoenix, AZ 85012-2902 - Phone
- (602) 462-1132
- Fax
- (602) 462-1135
- NPI assigned
- Apr 30, 2006
- Last updated
- Jul 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | RN065843 | AZ | Primary |
Addresses
Primary practice location
3003 N Central Ave
Suite 800
Phoenix, AZ 85012-2902
Mailing address
3003 N Central Ave
Phoenix, AZ 85012-2902
Phone (602) 462-1132
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170421001833 | AZ | Order and Referring Only - Nurse Practitioner | 0244336071 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN065843 | AZ | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glendale Healthcare Associates LLC | Past | Accepting new patients | |
| North Mountain Healthcare LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Bella Vita Health and Rehabilitation Center
- Skilled Nursing Facility
- Glendale, AZ
- NPI 1174518013
-
dba Coronado Care Center
- Skilled Nursing Facility
- Phoenix, AZ
- NPI 1376535674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1154388346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 N CENTRAL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122902",
"telephone_number": "602-462-1132",
"fax_number": "602-462-1135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 N CENTRAL AVE",
"address_2": "SUITE 800",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122902",
"telephone_number": "602-462-1132",
"fax_number": "602-462-1135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULLIN",
"first_name": "LINDA",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-30",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "AZ",
"license": "RN065843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.