Individual provider Active NPI

Kelly Lynn Zadravec, M.D.

  • Obstetrics & Gynecology Physician
  • Scottsdale, AZ
National Provider Identifier
1376541516
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33772 Issued in AZ
Practice address
20401 N 73Rd St Ste 295
Scottsdale, AZ 85255-4145
Phone
(480) 538-1333
Fax
(480) 538-1338
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 33772 AZ Primary

Addresses

Primary practice location

20401 N 73Rd St Ste 295
Scottsdale, AZ 85255-4145

Mailing address

20401 N 73Rd St Ste 295
Scottsdale, AZ 85255-4145
Phone (480) 538-1333

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33772AZMDObstetrics & Gynecology Physician
3372AZMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1376541516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20401 N 73RD ST STE 295",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554145",
            "telephone_number": "480-538-1333",
            "fax_number": "480-538-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20401 N 73RD ST STE 295",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554145",
            "telephone_number": "480-538-1333",
            "fax_number": "480-538-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADRAVEC",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "33772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.