Individual provider Active NPI

Kristine Lynn Vollmer, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1407383896
Registry record updated Jan 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
305567 Issued in AZ
Practice address
4375 E Irma LN
Phoenix, AZ 85050-4312
Phone
(480) 890-5800
NPI assigned
May 16, 2017
Last updated
Jan 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 305567 AZ Primary

Addresses

Primary practice location

4375 E Irma LN
Phoenix, AZ 85050-4312

Mailing address

4375 E Irma LN
Phoenix, AZ 85050-4312
Phone (480) 890-5800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240701002828 AZ Practitioner - Psychiatry 5597209544 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4375 E Irma LN
Phoenix, AZ 85050-4312
Phone (480) 890-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
305567AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Jan 5, 2025 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jan 5, 2025 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jan 5, 2025 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jan 5, 2025 Accepting new patients
Compassionate Assistance Past Accepting new patients

Locations

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

4375 E Irma Ln
Phoenix, AZ 85050
Phone (480) 890-5800

7575 E Earll Dr
Scottsdale, AZ 85251
Phone (480) 448-7500

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736035200000",
    "number": "1407383896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504312",
            "telephone_number": "480-890-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504312",
            "telephone_number": "480-890-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLMER",
        "first_name": "KRISTINE",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-16",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "305567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.