Individual provider Active NPI

Katherine Elizabeth Reynolds, MSN, FNP-C, RN

  • Family Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1629614623
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RNP233301 Issued in AZ
Practice address
595 N Dobson Rd Ste C48
Chandler, AZ 85224-4232
Phone
(480) 899-9430
Fax
(480) 899-9554
NPI assigned
Nov 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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 RNP233301 AZ Primary

Addresses

Primary practice location

595 N Dobson Rd Ste C48
Chandler, AZ 85224-4232

Mailing address

595 N Dobson Rd Ste C48
Chandler, AZ 85224-4232
Phone (480) 899-9430

Other practice location 1

1610 E Camelback Rd
Phoenix, AZ 85016-3902
Phone (602) 277-1727

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
I20211012001756 AZ Practitioner - Nurse Practitioner 0547668105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.04 of 100Reported as group
Quality
68.13
Improvement activities
40
Cost
72.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RNP233301AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Valley Cardiology, LTD CurrentSince Sep 12, 2023 Accepting new patients

Locations

20924 N John Wayne Pkwy
Ste D4
Maricopa, AZ 85139
Phone (480) 899-9430

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60309

Organizations & group practices 1

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": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1629614623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 N DOBSON RD STE C48",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244232",
            "telephone_number": "480-899-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 N DOBSON RD STE C48",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244232",
            "telephone_number": "480-899-9430",
            "fax_number": "480-899-9554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 E Camelback Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850163902",
            "country_code": "US",
            "telephone_number": "602-277-1727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "MSN, FNP-C, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP233301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.