Individual provider Active NPI

Cathy Ann Payne, MSN, ACNP-BC

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1285930925
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN 109904 AP- 1040 Issued in AZ
Practice address
11209 N Tatum Blvd Ste 260
Phoenix, AZ 85028
Phone
(602) 494-6800
Fax
(602) 494-6803
NPI assigned
Jan 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN 109904 AP- 1040 AZ Primary

Addresses

Primary practice location

11209 N Tatum Blvd Ste 260
Phoenix, AZ 85028

Mailing address

PO Box 6423
Chandler, AZ 85246-6423

Other identifiers 1

IdentifierTypeStateIssuer
524282MedicaidAZ

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
I20040119000191 AZ Practitioner - Nurse Practitioner 3476454851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ironwood Physicians PCGroup PAC ID 3577454842, 115 clinicians

Practice addresses (Care Compare)

11209 N Tatum Blvd
Suite 260
Phoenix, AZ 85028-6025
Phone (602) 494-6800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 109904 AP- 1040AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Oncology Associates PC Past Accepting new patients

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": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1285930925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6423",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11209 N TATUM BLVD STE 260",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85028",
            "telephone_number": "602-494-6800",
            "fax_number": "602-494-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "CATHY",
        "middle_name": "ANN",
        "credential": "MSN, ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "RN 109904  AP- 1040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "524282",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.