Individual provider Active NPI

Bryan Razo, FNP-C, PMHNP-C

  • Family Nurse Practitioner
  • San Luis, AZ
National Provider Identifier
1184351579
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
226505 Issued in AZ
Practice address
1922 E Cesar Chavez Blvd
Suite 7
San Luis, AZ 85336
Phone
(928) 750-4006
NPI assigned
Aug 4, 2022
Last updated
May 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 226505 AZ Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 226505 AZ

Addresses

Primary practice location

1922 E Cesar Chavez Blvd
Suite 7
San Luis, AZ 85336

Mailing address

PO Box 8691
San Luis, AZ 85349-6832
Phone (928) 750-4006

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
I20221108002062 AZ Practitioner - Nurse Practitioner 2062889850 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226505AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Walk-in Clinic, Inc. CurrentSince Oct 1, 2022 Accepting new patients
San Luis Walk-in Clinic, Inc. Multi-Specialty Current Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Razo Practice PLLC Family Current Accepting new patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients

Locations

1922 E Cesar Chavez Blvd
Ste 7
San Luis, AZ 85336
Phone (928) 750-4006

214 W Main St
Somerton, AZ 85350
Phone (928) 627-1120

950 E Main St
Bldg B
Somerton, AZ 85350
Phone (928) 236-8001

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations & group practices 6

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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1184351579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8691",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853496832",
            "telephone_number": "928-750-4006",
            "fax_number": "928-276-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 E CESAR CHAVEZ BLVD",
            "address_2": "SUITE 7",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "85336",
            "telephone_number": "928-750-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZO",
        "first_name": "BRYAN",
        "credential": "FNP-C, PMHNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "226505",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "226505",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis, AZ

Sources for this page

Verify at the official NPI Registry.