Individual provider Active NPI

Ryan M Mobley, NP

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1720022767
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP1873 Issued in AZ
Practice address
11209 N Tatum Blvd Ste 260
Phoenix, AZ 85028-6025
Phone
(602) 494-6800
Fax
(602) 494-6803
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP1873 AZ Primary

Addresses

Primary practice location

11209 N Tatum Blvd Ste 260
Phoenix, AZ 85028-6025

Mailing address

PO Box 6423
Chandler, AZ 85246-6423
Phone (480) 245-6286

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
I20040428000981 AZ Practitioner - Nurse Practitioner 1052308319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ironwood Physicians PCGroup PAC ID 3577454842, 115 clinicians

Practice addresses (Care Compare)

11209 N Tatum Blvd
Suite 260
Phoenix, AZ 85028-6025
Phone (602) 494-6800

Hospital & facility affiliations

  • Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP1873AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ironwood Physicians, PC Hematology & Oncology Current Accepting new patients
Ironwood Physicians, PC Hematology & Oncology CurrentSince Feb 1, 2021 Accepting new patients
Ironwood Physicians, PC Hematology & Oncology CurrentSince Feb 1, 2021 Accepting new patients

Locations

5810 W Beverly Ln
Glendale, AZ 85306
Phone (623) 312-3000

6111 E Arbor Ave
Mesa, AZ 85206
Phone (480) 981-1326

11209 N Tatum Blvd
Ste 260
Phoenix, AZ 85028
Phone (602) 494-6800

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.

Hospital & facility affiliations 1

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1720022767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6423",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466423",
            "telephone_number": "480-245-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11209 N TATUM BLVD STE 260",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286025",
            "telephone_number": "602-494-6800",
            "fax_number": "602-494-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "RYAN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP1873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.