Individual provider Active NPI

Michelle McDowell

  • Pediatric Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1245633502
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP7340 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-1900
Fax
(602) 933-1918
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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 RN155660 AZ
Pediatric Nurse Practitioner 363LP0200X AP7340 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1814

Other identifiers 1

IdentifierTypeStateIssuer
955708MedicaidAZ

Other names 1

  • Michelle Marie Royal Other name

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
I20141201002370 AZ Practitioner - Nurse Practitioner 5496077455 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN155660AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Nov 1, 2014 Accepting new patients
Phoenix Children'S Hospital CurrentSince Nov 1, 2014 Accepting new patients

Locations

19007 N 67th Ave
Glendale, AZ 85308
Phone (602) 933-0777

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

Organizations & group practices 2

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": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1245633502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-1900",
            "fax_number": "602-933-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN155660",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP7340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "955708",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ROYAL",
            "middle_name": "MARIE",
            "credential": "DNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.