Individual provider Active NPI

Debra Iglesias, FNP-BC

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1629302229
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP3474 Issued in AZ
Practice address
9321 W Thomas Rd Ste 420
Phoenix, AZ 85037-3399
Phone
(855) 776-7266
NPI assigned
Sep 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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 AP3474 AZ Primary

Addresses

Primary practice location

9321 W Thomas Rd Ste 420
Phoenix, AZ 85037-3399

Mailing address

140 N Litchfield Rd
Suite 200
Goodyear, AZ 85338-1277
Phone (602) 243-7277

Other identifiers 1

IdentifierTypeStateIssuer
483825MedicaidAZ

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP3474AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prosano Health Solutions, Inc. CurrentSince May 19, 2024 Accepting new patients
Prosano Health Solutions, Inc. PastSince May 19, 2024 Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Locations

9321 W Thomas Rd
Ste 420
Phoenix, AZ 85037

Interoperability endpoints

  • Direct secure messaging: debra.iglesias.1@27165.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1629302229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N LITCHFIELD RD",
            "address_2": "SUITE 200",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381277",
            "telephone_number": "602-243-7277",
            "fax_number": "602-323-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9321 W THOMAS RD STE 420",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373399",
            "telephone_number": "855-776-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGLESIAS",
        "first_name": "DEBRA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "483825",
            "state": "AZ"
        }
    ],
    "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 May 14, 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.

Verify at the official NPI Registry.