Active NPI
Sophie Gastelum
- Home Health Aide
- Queen Creek, AZ
National Provider Identifier
1366090102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 230136
- Practice address
- 20521 E Canary CT
Queen Creek, AZ 85142-3406 - Phone
- (208) 420-6678
- NPI assigned
- Aug 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 230136 | AZ | Primary |
Addresses
Primary practice location
20521 E Canary CT
Queen Creek, AZ 85142-3406
Mailing address
484 W Toledo St
Chandler, AZ 85225-4510
Phone (480) 306-3827
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 230136 | AZ | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566777600000",
"number": "1366090102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "484 W TOLEDO ST",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852254510",
"telephone_number": "480-306-3827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20521 E CANARY CT",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851423406",
"telephone_number": "208-420-6678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GASTELUM",
"first_name": "SOPHIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-26",
"last_updated": "2019-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "AZ",
"license": "230136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.