Individual provider Active NPI

Kaitlin Compton, FNP

  • Primary Care Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1689458739
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
227708 Issued in AZ
Practice address
4730 E Grant Rd
Tucson, AZ 85712-2703
Phone
(520) 290-0300
NPI assigned
Aug 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 227708 AZ Primary

Addresses

Primary practice location

4730 E Grant Rd
Tucson, AZ 85712-2703

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380

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
I20231010003783 AZ Practitioner - Nurse Practitioner 5799130845 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227708AZMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC CurrentSince Sep 1, 2023 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Sep 1, 2023 Accepting new patients

Locations

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

4730 E Grant Rd
Tucson, AZ 85712
Phone (520) 290-0300

Interoperability endpoints

  • Direct secure messaging: kcompton113483@westdirect.optum.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": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1689458739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122703",
            "telephone_number": "520-290-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMPTON",
        "first_name": "KAITLIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "227708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.