Individual provider Active NPI

Linda Mary Paullin, ANP

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1154388346
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN065843 Issued in AZ
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, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170421001833 AZ Order and Referring Only - Nurse Practitioner 0244336071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN065843AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.