Active NPI
Ryan Honomichl
- Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1568292720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 312082
- Practice address
- 3120 W Carefree Hwy Ste B15
Phoenix, AZ 85086-3201 - Phone
- (480) 608-5138
- NPI assigned
- Aug 2, 2024
- Last updated
- Aug 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 312082 | AZ | Primary |
Addresses
Primary practice location
3120 W Carefree Hwy Ste B15
Phoenix, AZ 85086-3201
Mailing address
22729 N 102ND Ave
Peoria, AZ 85383-2731
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 312082 | AZ | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1568292720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22729 N 102ND AVE",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853832731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3120 W CAREFREE HWY STE B15",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850863201",
"telephone_number": "480-608-5138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HONOMICHL",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-02",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "312082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.