Individual provider Active NPI

Kelly G Wright

  • Family Nurse Practitioner
  • Peoria, AZ
National Provider Identifier
1609496645
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
240520 Issued in AZ
Practice address
26826 N 85TH Dr
Peoria, AZ 85383-3624
Phone
(602) 750-5544
NPI assigned
Apr 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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 240520 AZ Primary

Addresses

Primary practice location

26826 N 85TH Dr
Peoria, AZ 85383-3624

Mailing address

26826 N 85TH Dr
Peoria, AZ 85383-3624
Phone (602) 750-5544

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
I20201230001199 AZ Practitioner - Nurse Practitioner 6305259821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Urgent Care Services LLCGroup PAC ID 4284921610, 207 clinicians

Practice addresses (Care Compare)

10330 N Scottsdale Rd
Suite 25
Scottsdale, AZ 85253-1427
Phone (602) 255-7625

11685 W Van Buren St
Avondale, AZ 85323-6904
Phone (623) 465-6420

13901 W Meeker Blvd
Sun City West, AZ 85375-4475
Phone (623) 465-6435

15521 W Bell Rd
Surprise, AZ 85374-3437
Phone (623) 465-6390

21980 N 83Rd Ave
Peoria, AZ 85383-1850
Phone (623) 465-6375

4232 W Bell Rd
Glendale, AZ 85308-4027
Phone (623) 465-6360

7611 W Cactus Rd
Peoria, AZ 85381-5203
Phone (623) 465-6315

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Arizona LLC CurrentSince Apr 30, 2023 Accepting new patients
Banner Urgent Care Services, LLC CurrentSince Apr 30, 2023 Accepting new patients
Banner Urgent Care Services, LLC CurrentSince Apr 30, 2023 Accepting new patients
Banner Urgent Care Arizona LLC CurrentSince Apr 30, 2023 Accepting new patients
Banner Urgent Care Arizona LLC Current Accepting new patients
Banner Urgent Care Services, LLC Current Accepting new patients

Locations

1676 E McMurray Blvd
Ste 1
Casa Grande, AZ 85122
Phone (520) 316-0688

3457 W White Mountain Blvd
Lakeside, AZ 85929
Phone (888) 264-2127

1121 S Gilbert Rd
Ste 101
Mesa, AZ 85204
Phone (480) 644-9355

101 E State Highway 260
Ste G
Payson, AZ 85541
Phone (888) 264-2127

21980 N 83rd Ave
Peoria, AZ 85383
Phone (623) 465-6375

4760 E Thunderbird Rd
Ste 1
Phoenix, AZ 85032
Phone (480) 827-5590

35945 N Gary Rd
San Tan Valley, AZ 85143
Phone (480) 827-5750

10330 N Scottsdale Rd
Ste 25
Scottsdale, AZ 85253
Phone (602) 255-7625

680 E Deuce of Clubs
Ste B
Show Low, AZ 85901
Phone (928) 537-2777

7066 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 514-0344

Organizations & group practices 6

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": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1609496645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26826 N 85TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833624",
            "telephone_number": "602-750-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26826 N 85TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833624",
            "telephone_number": "602-750-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KELLY",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "240520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.