Individual provider Active NPI

Renee M Little, PA

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1205806122
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2500 Issued in NU
Practice address
1400 S Dobson Rd
Mesa, AZ 85202
Phone
(480) 456-9500
Fax
(480) 820-7623
NPI assigned
Jan 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2500 NU Primary

Addresses

Primary practice location

1400 S Dobson Rd
Mesa, AZ 85202

Mailing address

PO Box 7127
Phoenix, AZ 85011-7127
Phone (480) 456-9500

Other identifiers 1

IdentifierTypeStateIssuer
577984MedicaidAZ

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
I20050624000888 AZ Practitioner - Physician Assistant 5395793152 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.68 of 100Reported as group
Quality
92.69
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Urgent Care, LLC CurrentSince Nov 11, 2019 Accepting new patients
Emergency Physicians Professional Association LTD Past Accepting new patients

Locations

3648 W Anthem Way
Bldg A100C
Anthem, AZ 85086
Phone (623) 434-6444

Organizations & group practices 8

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205806122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7127",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850117127",
            "telephone_number": "480-456-9500",
            "fax_number": "480-820-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85202",
            "telephone_number": "480-456-9500",
            "fax_number": "480-820-7623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "2500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "577984",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.