Individual provider Active NPI

Kristen Russell

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1295614931
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
322281 Issued in AZ
Practice address
4555 E Inverness Ave BLDG 3
Mesa, AZ 85206-4630
Phone
(480) 830-3900
NPI assigned
Aug 28, 2025
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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 322281 AZ Primary

Addresses

Primary practice location

4555 E Inverness Ave BLDG 3
Mesa, AZ 85206-4630

Mailing address

PO Box 30388
Mesa, AZ 85275-0388
Phone (480) 830-3900

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
I20251106004002 AZ Practitioner - Nurse Practitioner 7810487998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Sleep Physicians IncGroup PAC ID 5698905677, 27 clinicians

Practice addresses (Care Compare)

4555 E Inverness Ave
Suite 112
Mesa, AZ 85206-4630
Phone (480) 361-0110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322281AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Sleep Physicians, Inc CurrentSince Sep 9, 2025 Accepting new patients
Valley Oximetry Incorporated Past Accepting new patients
Valley Oximetry Incorporated Past Accepting new patients
Valley Oximetry Incorporated Past Accepting new patients
Valley Oximetry Incorporated PastSince Sep 9, 2025 Accepting new patients
Valley Oximetry Incorporated Past Accepting new patients
Valley Oximetry Incorporated Past Accepting new patients

Locations

4555 E Inverness Ave
Bldg 3
Mesa, AZ 85206
Phone (480) 361-0110

4555 E Inverness Ave
Ste 112
Mesa, AZ 85206
Phone (480) 361-0110

3777 Crossings Dr
Ste C
Prescott, AZ 86305
Phone (480) 361-0110

9767 N 91st St
#B104
Scottsdale, AZ 85258
Phone (480) 284-4015

9767 N 91st St
Ste B104
Scottsdale, AZ 85258

1790 E River Rd
Ste 130
Tucson, AZ 85718
Phone (480) 361-0110

Organizations & group practices 7

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": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1295614931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30388",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852750388",
            "telephone_number": "480-830-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 E INVERNESS AVE BLDG 3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064630",
            "telephone_number": "480-830-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "322281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.