Individual provider Active NPI

Kevin Sojourner, RN

  • Registered Nurse
  • Phoenix, AZ
National Provider Identifier
1346667052
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
180950 Issued in AZ
Practice address
3217 W Potter Dr
Phoenix, AZ 85027-6032
Phone
(760) 580-3920
NPI assigned
Mar 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 180950 AZ Primary

Addresses

Primary practice location

3217 W Potter Dr
Phoenix, AZ 85027-6032

Mailing address

3217 W Potter Dr
Phoenix, AZ 85027-6032
Phone (760) 580-3920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
180950AZMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1346667052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 W POTTER DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850276032",
            "telephone_number": "760-580-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 W POTTER DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850276032",
            "telephone_number": "760-580-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOJOURNER",
        "first_name": "KEVIN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "180950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.