Individual provider Active NPI

Shanu Khatana

  • Family Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1679426035
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
335624 Issued in AZ
Practice address
14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone
(847) 342-6910
NPI assigned
Feb 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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 335624 AZ Primary

Addresses

Primary practice location

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007

Mailing address

9515 Tamar TRL
Fort Wayne, IN 46825-7254

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
I20260320002755 AZ Practitioner - Nurse Practitioner 3274017835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical Group of Arizona LLCGroup PAC ID 2264593474, 159 clinicians

Practice addresses (Care Compare)

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone (623) 207-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
335624AZMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1771286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1679426035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 TAMAR TRL",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468257254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 W CELEBRATE LIFE WAY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383007",
            "telephone_number": "847-342-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATANA",
        "first_name": "SHANU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "335624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.