Individual provider Active NPI

Eileen M Gebhart, CRNA

  • Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1306820642
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
040108 Issued in AZ
Practice address
5750 W Thunderbird Rd
C300
Glendale, AZ 85306
Phone
(602) 938-2848
Fax
(602) 938-4401
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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 040108 AZ Primary

Addresses

Primary practice location

5750 W Thunderbird Rd
C300
Glendale, AZ 85306

Mailing address

5750 W Thunderbird Rd
C300
Glendale, AZ 85306
Phone (602) 938-2848

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
I20060206000132 AZ Practitioner - Nurse Practitioner 0244289494 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040108AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Medical Group, LLC Current Accepting new patients
Honorhealth Medical Group, LLC CurrentSince Apr 1, 2017 Accepting new patients
Honorhealth Medical Group, LLC CurrentSince Apr 1, 2017 Accepting new patients
Central Coast Medical Oncology Corp Past Accepting new patients
Sun Health Corporation Past Accepting new patients
Sun Health MRI Center Past Accepting new patients

Locations

6220 W Bell Rd
Ste 130
Glendale, AZ 85308
Phone (602) 547-7348

5750 W Thunderbird Rd
Ste C300
Glendale, AZ 85306
Phone (602) 368-3045

Organizations & group practices 6

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1306820642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD",
            "address_2": "C300",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85306",
            "telephone_number": "602-938-2848",
            "fax_number": "602-938-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD",
            "address_2": "C300",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85306",
            "telephone_number": "602-938-2848",
            "fax_number": "602-938-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBHART",
        "first_name": "EILEEN",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "040108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.