Individual provider Active NPI

Chauntel M Nessmith, NP

  • Nurse Practitioner
  • Peoria, AZ
National Provider Identifier
1285274027
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
236100 Issued in AZ
Practice address
7540 W Jenan Dr
Peoria, AZ 85345-1367
Phone
(602) 349-4887
NPI assigned
Jan 9, 2020
Last updated
Jan 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 236100 AZ Primary

Addresses

Primary practice location

7540 W Jenan Dr
Peoria, AZ 85345-1367

Mailing address

7540 W Jenan Dr
Peoria, AZ 85345-1367
Phone (602) 349-4887

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
I20210105001437 AZ Practitioner - Nurse Practitioner 7618380981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Consultants PLLCGroup PAC ID 4486079027, 3 clinicians

Practice addresses (Care Compare)

1851 N Gemini Dr
Flagstaff, AZ 86001-1607
Phone (602) 432-0146

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236100AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Consultants PLLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

1851 N Gemini Dr
Flagstaff, AZ 86001
Phone (928) 266-0118

3303 S Lindsay Rd
Ste 123
Gilbert, AZ 85297
Phone (480) 821-9339

Organizations & group practices 1

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 2

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": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1285274027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 W JENAN DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853451367",
            "telephone_number": "602-349-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 W JENAN DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853451367",
            "telephone_number": "602-349-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESSMITH",
        "first_name": "CHAUNTEL",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "236100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.