Kathryn Joy Packer, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP1240 Issued in AZ

Practice address

14478 W Windsor Ave
Goodyear, AZ 85395-2035

Phone

(602) 320-4818

Fax

(623) 320-4818

NPI assigned

Feb 27, 2006

Last updated

Jun 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Kathryn Flake Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathryn.packer.1@30093.direct.athenahealth.com

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.

• Teris Health Services LLC

  • Professional Counselor
  • Phoenix, AZ
  • NPI 1215422126
  Medicare reassignment NPD
• Katie Joy PLLC

  dba Katie Joy PLLC TELEMEDICINE

  • Family Medicine Physician
  • Goodyear, AZ
  • NPI 1366153165
  NPD Authorized official
• Prescott Healthcare Solutions LLC

  dba Optima Medical

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1821454505
  NPD
• Teri's Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1790374833
  NPD

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1700852928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14478 W WINDSOR AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952035",
            "telephone_number": "602-320-4818",
            "fax_number": "623-320-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14478 W WINDSOR AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952035",
            "telephone_number": "602-320-4818",
            "fax_number": "623-320-4818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 W Elliot Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852335301",
            "country_code": "US",
            "telephone_number": "480-963-6144",
            "fax_number": "480-899-1404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKER",
        "first_name": "KATHRYN",
        "middle_name": "JOY",
        "name_prefix": "Miss",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP1240",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022406",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0004221-C-NP",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP7236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "FLAKE",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stefanie J Outram, FNP-C
• Kristen Owens
• Own Your Path Wellness LLC
• Adil Nuri Ozkan, M.D.
• Kathleen Paat, LMSW
• Eva Josefina Padilla Garcia, M.D.
• Misty Lynn Pagan, DNP, AGNP-C
• Hilary Danielle Pagano, RN
• Joann Pagano, LPN
• Paincare of Arizona II, LLC

• Family Nurse Practitioner in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.