Individual provider Active NPI

Kesasi E Marsh

  • Family Nurse Practitioner
  • Avondale, AZ
National Provider Identifier
1164123550
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
288932 Issued in AZ
Practice address
12725 W Indian School Rd Ste E101
Avondale, AZ 85392-9525
Phone
(623) 471-9043
NPI assigned
Mar 13, 2023
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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 288932 AZ Primary

Addresses

Primary practice location

12725 W Indian School Rd Ste E101
Avondale, AZ 85392-9525

Mailing address

12725 W Indian School Rd # 101L-5
Avondale, AZ 85392-9520
Phone (623) 471-9043

Other practice location 1

12725 W Indian School Rd # 101L-5
Avondale, AZ 85392-9520
Phone (602) 471-9049

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
I20250915000826 AZ Practitioner - Nurse Practitioner 7719480763 Reassigns benefits to 1 organization
Practice locations: Avondale, AZ

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12725 W Indian School Rd
Suite E101
Avondale, AZ 85392-9525
Phone (623) 471-9043

1501 E Osborn Rd
Suite 101
Phoenix, AZ 85014-5350

575 S Cotton LN
Apt 1087
Goodyear, AZ 85338-4989

575 S Cotton LN Apt
Suite 1087
Goodyear, AZ 85338-4989

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Goodyear Family Nurse Practice LLC CurrentSince Nov 1, 2023 Accepting new patients
PV Mountain Medical PLLC CurrentSince Jul 1, 2025 Accepting new patients
Kesasi Marsh PLLC CurrentSince Jun 29, 2025 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC PastSince Mar 1, 2023 Accepting new patients
Med-Cure Internal Medicine, PLC PastSince Mar 1, 2023 Accepting new patients

Locations

12725 W Indian School Rd
#101L5
Avondale, AZ 85392
Phone (602) 471-9049

12725 W Indian School Rd
Ste E101
Avondale, AZ 85392
Phone (480) 448-2929

12725 W Indian School Rd
Ste E115
Avondale, AZ 85392
Phone (602) 456-7199

436 E Southern Ave
Tempe, AZ 85282
Phone (480) 336-2039

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBDIAA

Organizations & group practices 5

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": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1164123550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12725 W INDIAN SCHOOL RD # 101L-5",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929520",
            "telephone_number": "623-471-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 W INDIAN SCHOOL RD STE E101",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929525",
            "telephone_number": "623-471-9043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12725 W Indian School Rd # 101L-5",
            "address_purpose": "LOCATION",
            "city": "Avondale",
            "state": "AZ",
            "postal_code": "853929520",
            "country_code": "US",
            "telephone_number": "602-471-9049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSH",
        "first_name": "KESASI",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-13",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "288932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.