Individual provider Active NPI

Kariessa Taylor Welch, FNP-C

  • Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1669234589
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
236624 Issued in AZ
Practice address
20734 E Maya Rd Ste 101
Queen Creek, AZ 85142-2651
Phone
(888) 663-6631
Fax
(415) 252-7176
NPI assigned
Jan 25, 2024
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 236624 AZ Primary
Family Nurse Practitioner 363LF0000X 236624 AZ

Addresses

Primary practice location

20734 E Maya Rd Ste 101
Queen Creek, AZ 85142-2651

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other names 1

  • Kariessa Taylor Rosenlund Former name

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
I20240328004010 AZ Practitioner - Nurse Practitioner 1456799261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iora Senior Health LLCGroup PAC ID 0143520189, 117 clinicians
Omg Arizona LLCGroup PAC ID 9638499247, 7 clinicians

Practice addresses (Care Compare)

2196 E Williams Field Rd
Suite 116
Gilbert, AZ 85295-0755
Phone (888) 405-6396

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iora Senior Health, LLC CurrentSince May 6, 2024 Accepting new patients
Omg Arizona, LLC CurrentSince Mar 6, 2024 Accepting new patients
Iora Senior Health, LLC Current Accepting new patients
Iora Senior Health, LLC CurrentSince May 6, 2024 Accepting new patients
One Medical Group of Arizona, PC Past Accepting new patients

Locations

2196 E Williams Field Rd
Ste 116
Gilbert, AZ 85295
Phone (480) 237-1395

2201 E Camelback Rd
Ste 101A
Phoenix, AZ 85016
Phone (602) 218-4075

3137 W Indian School Rd
Phoenix, AZ 85017
Phone (602) 325-5570

20734 E Maya Rd
Ste 101
Queen Creek, AZ 85142
Phone (888) 663-6631

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

Interoperability endpoints

  • FHIR API: https://api.prod.1life.com/fhir/4.0

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1669234589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20734 E MAYA RD STE 101",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851422651",
            "telephone_number": "888-663-6631",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "KARIESSA",
        "middle_name": "TAYLOR",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "236624",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "236624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARIESSA",
            "last_name": "ROSENLUND",
            "middle_name": "TAYLOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.