Rosa Shantal Kingsley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

236423 Issued in AZ

Practice address

10599 N Tatum Blvd Ste F151
Paradise Valley, AZ 85253-1053

Phone

(480) 991-9271

NPI assigned

Apr 11, 2024

Last updated

Apr 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Payson Medical Center Hospital, Payson, AZ, CCN 031318

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Scottsdale, AZ
  • NPI 1609229764
  Medicare reassignment NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • San Tan Valley, AZ
  • NPI 1942653019
  NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1962855031
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Health

  dba Banner Payson Medical Center

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340
  Care Compare affiliation

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1437903028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10599 N TATUM BLVD STE F151",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531053",
            "telephone_number": "480-991-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10599 N TATUM BLVD STE F151",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531053",
            "telephone_number": "480-991-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSLEY",
        "first_name": "ROSA",
        "middle_name": "SHANTAL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "236423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsar Inc. (Sunergy HomeCare - Scottsdale)
• Kennewick Radiology Group PC
• Alan Kenneth Ketover, M.D.
• Ann Kharrat, DMD
• Reem Kidess, D.D.S.
• Louis Carlton Kirby II, MD
• Lester Robert Klebe, DPM
• Alexandra Berney Klein, PH.D.
• Neda Kobari Ghotbi
• Sheldon Paul Kottle, M.D., MPH, FACP

• Family Nurse Practitioner in Paradise Valley, AZ
• Providers in Paradise Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.