Individual provider Active NPI

Christine Machele Leach, FNP

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1356924179
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
256066 Issued in AZ
Practice address
18433 N 19TH Ave
Phoenix, AZ 85023-1359
Phone
(888) 698-6727
NPI assigned
Apr 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 256066 AZ Primary

Addresses

Primary practice location

18433 N 19TH Ave
Phoenix, AZ 85023-1359

Mailing address

18275 N 59TH Ave # K162
Glendale, AZ 85308-1260
Phone (602) 755-0800

Other identifiers 1

IdentifierTypeStateIssuer
15128120OtherAZCAQH ID

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
I20210816003716 AZ Practitioner - Nurse Practitioner 3870998727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

14541 W Indian School Rd
Suite 600
Goodyear, AZ 85395-9243
Phone (888) 698-6727

18275 N 59TH Ave
Suite 162
Glendale, AZ 85308-1254
Phone (888) 698-6727

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group Arizona LLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

18275 N 59th Ave
Ste 162
Glendale, AZ 85308
Phone (602) 547-8184

5620 W Thunderbird Rd
Ste B2
Glendale, AZ 85306
Phone (602) 547-9405

18275 N 59th Ave
Ste 162K
Glendale, AZ 85308
Phone (602) 547-8184

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

18433 N 19th Ave
Phoenix, AZ 85023
Phone (623) 582-9894

Interoperability endpoints

  • Direct secure messaging: christine.leach.1@19654.direct.athenahealth.com

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": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1356924179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE # K162",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081260",
            "telephone_number": "602-755-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18433 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231359",
            "telephone_number": "888-698-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "CHRISTINE",
        "middle_name": "MACHELE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "256066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "15128120",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.