Individual provider Active NPI

Savannah Aycock

  • Women's Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1346095973
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
306292 Issued in AZ
Practice address
6601 W Thomas Rd
Phoenix, AZ 85033-5700
Phone
(602) 323-3344
NPI assigned
Apr 18, 2024
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 306292 AZ Primary

Addresses

Primary practice location

6601 W Thomas Rd
Phoenix, AZ 85033-5700

Mailing address

3003 N Central Ave Ste 1600
Phoenix, AZ 85012-2908

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
I20240517000707 AZ Practitioner - Nurse Practitioner 2163863432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Park Health CenterGroup PAC ID 8325949647, 117 clinicians

Practice addresses (Care Compare)

6601 W Thomas Rd
Phoenix, AZ 85033-5700
Phone (602) 243-7277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306292AZMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center CurrentSince Apr 29, 2024 Accepting new patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Apr 29, 2024 Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients

Locations

2702 N 3rd St
Ste 4020
Phoenix, AZ 85004
Phone (602) 323-3345

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

635 E Baseline Rd
Phoenix, AZ 85042

6601 W Thomas Rd
Phoenix, AZ 85033

Organizations & group practices 4

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": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1346095973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850335700",
            "telephone_number": "602-323-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYCOCK",
        "first_name": "SAVANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "306292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.