Charlann Carroll Staab, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

220405 Issued in AZ

Practice address

10133 N 92ND St Ste 102
Scottsdale, AZ 85258-4556

Phone

(480) 644-6416

NPI assigned

Mar 11, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1184259962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 N MELODY CIR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852251695",
            "telephone_number": "480-797-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10133 N 92ND ST STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584556",
            "telephone_number": "480-644-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAAB",
        "first_name": "CHARLANN",
        "middle_name": "CARROLL",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "220405",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "220405",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "220405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "220405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Srivani K Srikantiah, M.D.
• Linda Susan Sroka, NP
• SSB Ventures, LLC (Medi-Weightloss Clinics-Scottsdale)
• Heather N St Peter, M.D.
• Lynn M St Pierre, ANP
• Tiffany Marie Staab, FNP-C
• Megan Stacey, LAC
• Nikita Stachnik, PHARMD
• Tiffany Anne Stadnick, MD
• Staff Assistance, Inc. (Assisted Healthcare Services)

• Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.

Verify at the official NPI Registry.