Individual provider Active NPI

Kortni Patterson

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1437812179
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
266617 Issued in AZ
Practice address
2724 S Signal Butte Rd
Mesa, AZ 85209-2104
Phone
(480) 481-7210
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X F09210893 AZ
Family Nurse Practitioner 363LF0000X 266617 AZ Primary

Addresses

Primary practice location

2724 S Signal Butte Rd
Mesa, AZ 85209-2104

Mailing address

PO Box 932958
Cleveland, OH 44193-0028
Phone (480) 481-7210

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
I20220218000273 AZ Practitioner - Nurse Practitioner 6608260518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.28 of 100Reported as group
Quality
69.93
Promoting interoperability
100
Improvement activities
40
Cost
77.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
266617AZMDFamily Nurse Practitioner
F09210893AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Arizona LLC Multi-Specialty CurrentSince Feb 7, 2022 Accepting new patients

Locations

2724 S Signal Butte Rd
Mesa, AZ 85209
Phone (480) 481-7210

1935 N Stapley Dr
Mesa, AZ 85203
Phone (480) 339-6178

2727 W Bell Rd
Phoenix, AZ 85053
Phone (602) 680-2386

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

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": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1437812179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028",
            "telephone_number": "480-481-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 S SIGNAL BUTTE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852092104",
            "telephone_number": "480-481-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KORTNI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "F09210893",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "266617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.