Individual provider Active NPI

Sanana Phillips, NP

  • Family Nurse Practitioner
  • Kingman, AZ
National Provider Identifier
1275187916
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
230133 Issued in AZ
Practice address
3801 Santa Rosa Dr
Kingman, AZ 86401-2311
Phone
(928) 681-8530
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 230133 AZ Primary

Addresses

Primary practice location

3801 Santa Rosa Dr
Kingman, AZ 86401-2311

Mailing address

3801 Santa Rosa Dr
Kingman, AZ 86401-2311

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
I20191023003609 AZ Practitioner - Nurse Practitioner 9335471325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as group
Quality
84.49
Promoting interoperability
83
Improvement activities
40
Cost
79.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
230133AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Healthcare, Inc CurrentSince Oct 1, 2019 Accepting new patients
Kingman Healthcare, Inc Current Accepting new patients
Kingman Healthcare, Inc Family CurrentSince Oct 1, 2019 Accepting new patients

Locations

3801 Santa Rosa Dr
Ste 400
Kingman, AZ 86401
Phone (928) 681-8530

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

2226 Hualapai Mountain Rd
Ste 101
Kingman, AZ 86401
Phone (928) 681-8530

3801 Santa Rosa Dr
Kingman, AZ 86401
Phone (928) 263-5000

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1275187916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 SANTA ROSA DR",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864012311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SANTA ROSA DR",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864012311",
            "telephone_number": "928-681-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SANANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "230133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.