Gloria Yvonne Endicott, MSN,RN,CNL, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95003184 Issued in CA

Practice address

1810 Mesquite Ave Ste B
Lake Havasu City, AZ 86403-5886

Phone

(928) 453-4600

NPI assigned

Jun 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anmed Urgent Care LLCGroup PAC ID 1759819261, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

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.

• Anmed Urgent Care LLC

  dba AnMed Urgent Care

  • Urgent Care Clinic/Center
  • Anderson, SC
  • NPI 1467289637
  Medicare reassignment Care Compare group NPD
• Doctors Hospital Physician Services LLC

  dba Affinity Gastroenterology Services

  • Endoscopy Clinic/Center
  • Canton, OH
  • NPI 1013319144
  NPD (past)
• Doctors Hospital Physician Services LLC

  • Family Medicine Physician
  • Massillon, OH
  • NPI 1801858501
  NPD (past)

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

{
    "created_epoch": "1371254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1598104218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2582 PARK ST",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430469033",
            "telephone_number": "937-594-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MESQUITE AVE STE B",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035886",
            "telephone_number": "928-453-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDICOTT",
        "first_name": "GLORIA",
        "middle_name": "YVONNE",
        "credential": "MSN,RN,CNL, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-15",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.14569-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95003184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Maxie Elliott
• Embody Chiropractic Center PLLC
• Embody Wellness Chiropractic Center PLLC (Embody Wellness Chiropractic Center)
• Emergency Physicians Medical Group
• Daniel Rawn Emig, M.D.
• Enduro Medical Enterprises, LLC
• Entc LLC (Eagles Nest)
• Crystal Rose Eppling, OD
• Ariel Esquibel, OD
• Stephanie Ethridge

• Family Nurse Practitioner in Lake Havasu City, AZ
• Providers in Lake Havasu City, 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 Nov 22, 2019; 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.