Individual provider Active NPI

Douglas W Pope, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1225154545
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN075687 Issued in AZ
Practice address
9250 N. 3Rd Street
Suite 3010
Phoenix, AZ 85020-2412
Phone
(602) 861-1168
Fax
(602) 861-1763
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP1932 AZ
Family Nurse Practitioner 363LF0000X RN075687 AZ Primary

Addresses

Primary practice location

9250 N. 3Rd Street
Suite 3010
Phoenix, AZ 85020-2412

Mailing address

Dept 8511
Los Angeles, CA 90084-8511
Phone (602) 861-1168

Other identifiers 1

IdentifierTypeStateIssuer
212690MedicaidAZ

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
I20070808000058 AZ Practitioner - Nurse Practitioner 4789775644 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Healthcare Medical Associates of Arizona PCGroup PAC ID 5597946350, 33 clinicians

Practice addresses (Care Compare)

6644 E Baywood Ave
Mesa, AZ 85206-1747
Phone (480) 321-2000

Hospital & facility affiliations

  • Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
  • Banner Heart Hospital Hospital, Mesa, AZ, CCN 030105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP1932AZMDNurse Practitioner
RN075687AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Group of Arizona Professional Corporation Nurse Practitioner CurrentSince Nov 2, 2019 Accepting new patients
Arizona Acute Medical Services 1 PC CurrentSince Oct 1, 2019 Accepting new patients
North Phoenix Heart Center Past Accepting new patients

Locations

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1225154545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 8511",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900848511",
            "telephone_number": "602-861-1168",
            "fax_number": "602-678-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 N. 3RD STREET",
            "address_2": "SUITE 3010",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202412",
            "telephone_number": "602-861-1168",
            "fax_number": "602-861-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPE",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP1932",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN075687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212690",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.