Individual provider Active NPI

Joan Ardavanis

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1508249061
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP7882 Issued in AZ
Practice address
1440 S. Country Club Dr.
#30
Mesa, AZ 85210
Phone
(480) 505-0500
NPI assigned
Jul 2, 2015
Last updated
Apr 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP7882 AZ Primary

Addresses

Primary practice location

1440 S. Country Club Dr.
#30
Mesa, AZ 85210

Mailing address

1440 S Country Club Dr
#30
Mesa, AZ 85210-9701
Phone (480) 505-0500

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
I20180110002977 AZ Practitioner - Nurse Practitioner 0840559274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9312 E Raintree Dr
Scottsdale, AZ 85260-2094
Phone (480) 374-4339

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP7882AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Accurate Care Chiropractic & Acupuncture CurrentSince Apr 1, 2021 Accepting new patients
Mulligan Medical LLC CurrentSince Apr 27, 2021 Accepting new patients
Elite Integrative Group PLLC Past Accepting new patients

Locations

18261 N Pima Rd
Ste 115
Scottsdale, AZ 85255
Phone (602) 493-2228

9312 E Raintree Dr
Scottsdale, AZ 85260
Phone (480) 374-4339

9700 N 91st St
Ste A115
Scottsdale, AZ 85258
Phone (480) 922-1376

Organizations & group practices 3

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1508249061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 S COUNTRY CLUB DR",
            "address_2": "#30",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852109701",
            "telephone_number": "480-505-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 S. COUNTRY CLUB DR.",
            "address_2": "#30",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85210",
            "telephone_number": "480-505-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDAVANIS",
        "first_name": "JOAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.