Individual provider Active NPI

Karin B Spiess, CPNP-PC

  • Pediatric Nurse Practitioner
  • Sacaton, AZ
National Provider Identifier
1649266883
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95028 Issued in AZ
Practice address
483 W Seed Farm Rd
Sacaton, AZ 85147-5000
Phone
(602) 528-1200
Fax
(602) 528-1255
NPI assigned
Sep 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 95028 AZ Primary

Addresses

Primary practice location

483 W Seed Farm Rd
Sacaton, AZ 85147-5000

Mailing address

PO Box 38
Sacaton, AZ 85147-0001
Phone (602) 528-1200

Other identifiers 1

IdentifierTypeStateIssuer
177643MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180112000574 TX Practitioner - Nurse Practitioner 6406883735 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95028AZMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care CurrentSince Jan 2, 2018 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care Corporation CurrentSince Jan 2, 2018 Accepting new patients

Organizations & group practices 4

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1649266883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470001",
            "telephone_number": "602-528-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W SEED FARM RD",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851475000",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIESS",
        "first_name": "KARIN",
        "middle_name": "B",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "95028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177643",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacaton, AZ

Sources for this page

Verify at the official NPI Registry.