Individual provider Active NPI

Brenda Marcella Vogl, NURSE PRACTIONER

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1306972989
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0151 Issued in AZ
Practice address
4545 E Chandler Blvd
Suite 305
Phoenix, AZ 85048-7643
Phone
(480) 785-7546
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0151 AZ Primary

Addresses

Primary practice location

4545 E Chandler Blvd
Suite 305
Phoenix, AZ 85048-7643

Mailing address

1321 N Longmore St
Chandler, AZ 85224-8564
Phone (480) 227-1618

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
I20070725000526 AZ Practitioner - Nurse Practitioner 8820199540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Premier Dermatology, LLCGroup PAC ID 2860518891, 2 clinicians

Practice addresses (Care Compare)

4545 E Chandler Blvd
305 Arizona Premier Dermatology
Phoenix, AZ 85048-7546
Phone (480) 785-7546

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0151AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Premier Dermatology, LLC Nurse Practitioner CurrentSince Aug 1, 2010 Accepting new patients

Locations

4545 E Chandler Blvd
Ste 305
Phoenix, AZ 85048
Phone (480) 785-7546

4545 E Chandler Blvd
Phoenix, AZ 85048
Phone (480) 728-4000

4545 E Chandler Blvd
Ste 3
Phoenix, AZ 85048
Phone (480) 785-7546

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1306972989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 N LONGMORE ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852248564",
            "telephone_number": "480-227-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E CHANDLER BLVD",
            "address_2": "SUITE 305",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487643",
            "telephone_number": "480-785-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGL",
        "first_name": "BRENDA",
        "middle_name": "MARCELLA",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "0151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.