NPIMap

Organization Active NPI

Family Nurse Practice P.L.L.C.

  • Primary Care Clinic/Center
  • Mesa, AZ
National Provider Identifier
1619606506
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
FAMILY NURSE PRACTICE P.L.L.C.
Practice address
1727 W Emelita Ave Apt 2104
Mesa, AZ 85202-3168
Phone
(480) 553-1547
Fax
(480) 615-9039
NPI assigned
Jun 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Authorized official

Name
Dr. Gary Rayburn, NP-C
Title
Owner
Phone
(480) 553-1547

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Corporate Health Clinic/Center 261QC1800X
Health Service Clinic/Center 261QH0100X
Medical Specialty Clinic/Center 261QM2500X
Primary Care Clinic/Center 261QP2300X Primary
Rural Health Clinic/Center 261QR1300X
Point of Service 305S00000X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1727 W Emelita Ave Apt 2104
Mesa, AZ 85202-3168

Mailing address

1727 W Emelita Ave Apt 2104
Mesa, AZ 85202-3168
Phone (480) 553-1547

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1619606506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 W EMELITA AVE APT 2104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852023168",
            "telephone_number": "480-553-1547",
            "fax_number": "480-615-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 W EMELITA AVE APT 2104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852023168",
            "telephone_number": "480-553-1547",
            "fax_number": "480-615-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY NURSE PRACTICE P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "RAYBURN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-553-1547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.