Individual provider Active NPI

Phyllis Wambui Kamau

  • Licensed Practical Nurse
  • Gilbert, AZ
National Provider Identifier
1710772454
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
288914 Issued in AZ
Practice address
633 E Ray Rd Ste 130
Gilbert, AZ 85296-4206
Phone
(480) 812-3680
NPI assigned
Apr 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 288914 AZ Primary

Addresses

Primary practice location

633 E Ray Rd Ste 130
Gilbert, AZ 85296-4206

Mailing address

633 E Ray Rd Ste 130
Gilbert, AZ 85296-4206
Phone (480) 812-3680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
288914AZMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1744416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1710772454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 E RAY RD STE 130",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964206",
            "telephone_number": "480-812-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 E RAY RD STE 130",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964206",
            "telephone_number": "480-812-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMAU",
        "first_name": "PHYLLIS",
        "middle_name": "WAMBUI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-12",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "288914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.