Active NPI
Phyllis Khao
- Occupational Therapist
- Scottsdale, AZ
National Provider Identifier
1710422613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7458
- Practice address
- 13400 E. Shea Blvd.
Scottsdale, AZ 85259 - Phone
- (480) 301-8000
- Fax
- (860) 253-5030
- NPI assigned
- Dec 31, 2016
- Reactivated
- Feb 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Occupational Therapist | 225X00000X | 7458 | AZ | Primary |
Addresses
Primary practice location
13400 E. Shea Blvd.
Scottsdale, AZ 85259
Mailing address
13400 E. Shea Blvd.
Scottsdale, AZ 85259
Phone (480) 301-8000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pkhao582119@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7458 | AZ | MD | Occupational Therapist |
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 and National Provider Directory roles.
-
dba Mayo Clinic Scottsdale
- Multi-Specialty Clinic/Center
- Scottsdale, AZ
- NPI 1558332494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1710422613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13400 E. SHEA BLVD.",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85259",
"telephone_number": "480-301-8000",
"fax_number": "860-731-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13400 E. SHEA BLVD.",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85259",
"telephone_number": "480-301-8000",
"fax_number": "860-253-5030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAO",
"first_name": "PHYLLIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-31",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"deactivation_date": "2019-02-19",
"reactivation_date": "2019-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "7458",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pkhao582119@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "13400 E. Shea Blvd.",
"city": "Scottsdale",
"state": "AZ",
"country_code": "US",
"postal_code": "85259",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.