Active NPI
Aleysa Raymond, NP
- Gerontology Registered Nurse
- Peoria, AZ
National Provider Identifier
1356712285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Registered Nurse
- License
- AP9620
- Practice address
- 13128 N. 94TH Dr
Suite 100
Peoria, AZ 85381-4252 - Phone
- (623) 876-8816
- Fax
- (623) 298-0168
- NPI assigned
- Oct 19, 2015
- Last updated
- Jan 30, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN203795 | AZ | |
| Gerontology Registered Nurse | 163WG0600X | 041.385179 | IL | |
| Gerontology Registered Nurse | 163WG0600X | AP9620 | AZ | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | 209.013442 | IL |
Addresses
Primary practice location
13128 N. 94TH Dr
Suite 100
Peoria, AZ 85381-4252
Mailing address
13128 N. 94TH Dr
Suite 100
Peoria, AZ 85381-4252
Phone (623) 876-8816
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP9620 | AZ | MD | Gerontology Registered Nurse |
| 041.385179 | IL | MD | Gerontology Registered Nurse |
| 209.013442 | IL | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485734400000",
"number": "1356712285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13128 N. 94TH DR",
"address_2": "SUITE 100",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814252",
"telephone_number": "623-876-8816",
"fax_number": "623-298-0168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13128 N. 94TH DR",
"address_2": "SUITE 100",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814252",
"telephone_number": "623-876-8816",
"fax_number": "623-298-0168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYMOND",
"first_name": "ALEYSA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-19",
"last_updated": "2017-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AZ",
"license": "RN203795",
"primary": false
},
{
"code": "163WG0600X",
"taxonomy_group": "",
"desc": "Registered Nurse, Gerontology",
"state": "IL",
"license": "041.385179",
"primary": false
},
{
"code": "163WG0600X",
"taxonomy_group": "",
"desc": "Registered Nurse, Gerontology",
"state": "AZ",
"license": "AP9620",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "IL",
"license": "209.013442",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.