Individual provider Active NPI

Aleysa Raymond, NP

  • Gerontology Registered Nurse
  • Peoria, AZ
National Provider Identifier
1356712285
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
AP9620 Issued in AZ
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, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
AP9620AZMDGerontology Registered Nurse
041.385179ILMDGerontology Registered Nurse
209.013442ILMDGerontology 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.

Verify at the official NPI Registry.