Individual provider Active NPI

Shaun Christian Java

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1265297097
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
306567 Issued in AZ
Practice address
19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone
(623) 879-6100
NPI assigned
Feb 20, 2024
Reactivated
May 28, 2024
Last updated
Jun 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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 306567 AZ Primary
Registered Nurse 163W00000X RN174293 AZ

Addresses

Primary practice location

19829 N 27TH Ave
Phoenix, AZ 85027-4001

Mailing address

12124 W Cottontail LN
Peoria, AZ 85383-5829
Phone (602) 299-4548

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
I20240702001779 AZ Practitioner - Nurse Practitioner 3173067014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of ArizonaGroup PAC ID 5496125569, 38 clinicians
CH Specialty Services Az LLCGroup PAC ID 7214301621, 17 clinicians

Practice addresses (Care Compare)

13755 N Litchfield Rd
Suite 105
Surprise, AZ 85379-4288
Phone (337) 991-9276

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306567AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Arizona CurrentSince Jun 26, 2024 Accepting new patients

Locations

13755 N Litchfield Rd
Ste 105
Surprise, AZ 85379
Phone (623) 248-7404

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

5750 Johnston St
Ste 205
Lafayette, LA 70503
Phone (337) 580-3330

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1265297097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12124 W COTTONTAIL LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853835829",
            "telephone_number": "602-299-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19829 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274001",
            "telephone_number": "623-879-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVA",
        "first_name": "SHAUN",
        "middle_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "deactivation_date": "2024-04-26",
        "reactivation_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "306567",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN174293",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.