Kristina A McKinzie, FNP
Individual provider Active NPI Family Nurse Practitioner · San Tan Valley, AZ
NPI 1306569090 · NPPES record last updated May 5, 2025
Key facts
- NPI
- 1306569090
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 314933 (AZ)
- Practice address
- 10593 E American Pride Dr
San Tan Valley, AZ 85143-7978 - Phone
- (619) 201-0835
- NPI assigned
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10593 E American Pride Dr
San Tan Valley, AZ 85143-7978
Phone (619) 201-0835
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250115003106 | AZ | Practitioner - Nurse Practitioner | 0244768406 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revive Wellness and Beauty, LLC | Family | Current |
Accepting new patients |
| Mulberry Medical LLC | Current |
Accepting new patients | |
| Mobileonedocs, LLC | Current |
Accepting new patients | |
| Mobileonedocs, LLC | Family | Current |
Accepting new patients |
| MD Medical Group, LLC | Current |
Accepting new patients | |
| Plastic and Peripheral Nerve Surgery LLC | Past | Accepting new patients |
Locations
7500 N Dreamy Draw Dr
Ste 211A
Phoenix, AZ 85020
Phone (602) 878-1783
10250 N 92nd St
Ste 308
Scottsdale, AZ 85258
Phone (480) 614-6655
10115 E Bell Rd
Ste 107234
Scottsdale, AZ 85260
Phone (480) 843-9877
5801 S McClintock Dr
Ste 104
Tempe, AZ 85283
Phone (623) 220-2601
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AHHIDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 314933 | AZ | Yes |
Addresses
Primary practice location
10593 E American Pride Dr
San Tan Valley, AZ 85143-7978
Mailing address
10593 E American Pride Dr
San Tan Valley, AZ 85143-7978
Phone (619) 201-0835
Other providers in San Tan Valley, AZ
- Mercedes R McCombs
- Andra Sue McConnell
- Melanie Kay McDaniel
- Crystal Lynn McElroy
- Emily McFadden
- Cassandra J. McLaughlin
- Meaningful Life Behavioral Health
- Medi-Ride LLC
- Alexa A Medina
- Anithsia Mejia
All providers in San Tan Valley, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.