Individual provider Active NPI

Cynthia L Legris, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1285607051
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN 081310 Issued in AZ
Practice address
500 W Thomas Rd
Suite 200
Phoenix, AZ 85013-4224
Phone
(602) 200-9159
Fax
(602) 200-9949
NPI assigned
Feb 10, 2006
Last updated
Sep 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN 081310 AZ Primary

Addresses

Primary practice location

500 W Thomas Rd
Suite 200
Phoenix, AZ 85013-4224

Mailing address

500 W Thomas Rd Ste 220
Phoenix, AZ 85013-4215
Phone (602) 200-9159

Other identifiers 1

IdentifierTypeStateIssuer
358730MedicaidAZ

Other names 1

  • Cynthia Montanaro Geiss Former 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
I20050504001114 AZ Practitioner - Nurse Practitioner 2769422138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 081310AZMDPediatric Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1285607051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 220",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134215",
            "telephone_number": "602-200-9159",
            "fax_number": "602-200-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134224",
            "telephone_number": "602-200-9159",
            "fax_number": "602-200-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGRIS",
        "first_name": "CYNTHIA",
        "middle_name": "L",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "RN 081310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358730",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "GEISS",
            "middle_name": "MONTANARO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.