Individual provider Active NPI

Karissa Eileen Cain, DNP, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1235800319
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
270531 Issued in AZ
Practice address
4131 N 24TH St Ste B102
Phoenix, AZ 85016-6231
Phone
(480) 882-4545
Fax
(602) 903-7091
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN183023 AZ
Family Nurse Practitioner 363LF0000X 270531 AZ Primary

Addresses

Primary practice location

4131 N 24TH St Ste B102
Phoenix, AZ 85016-6231

Mailing address

4131 N 24TH St Ste B102
Phoenix, AZ 85016-6231
Phone (480) 882-4545

Other identifiers 1

IdentifierTypeStateIssuer
RN183023OtherAZAZ BOARD OF NURSING RN

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
I20220414001820 AZ Practitioner - Nurse Practitioner 0840686051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4131 N 24TH St
Suite B102
Phoenix, AZ 85016-6231
Phone (480) 882-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN183023AZMDRegistered Nurse
270531AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Outreach Access to Health CurrentSince Nov 27, 2024 Accepting new patients
Neighborhood Outreach Access to Health CurrentSince Nov 27, 2024 Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients

Locations

11851 N 51st Ave
Ste B110
Glendale, AZ 85304

11851 N 51st Ave
Ste F140
Glendale, AZ 85304
Phone (623) 428-0001

16251 N Cave Creek Rd
Phoenix, AZ 85032

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

7500 N Dreamy Draw Dr
Ste 145
Phoenix, AZ 85020

9015 N 3rd St
Phoenix, AZ 85020

20440 N 27th Ave
Phoenix, AZ 85027

8705 E McDowell Rd
Scottsdale, AZ 85257

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1235800319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 N 24TH ST STE B102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166231",
            "telephone_number": "480-882-4545",
            "fax_number": "602-903-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 N 24TH ST STE B102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166231",
            "telephone_number": "480-882-4545",
            "fax_number": "602-903-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "KARISSA",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN183023",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "270531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BOARD OF NURSING RN",
            "identifier": "RN183023",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.