Individual provider Active NPI

Nichole Townsend, MD

  • Pediatric Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1720349095
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
47520 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-4660
Fax
(602) 933-8945
NPI assigned
Jun 4, 2012
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 47520 AZ
Internal Medicine Physician 207R00000X R73384 AZ
Pediatric Anesthesiology Physician 207LP3000X 47520 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Other practice location 1

1111 E McDowell Rd
LL2
Phoenix, AZ 85006-2612
Phone (602) 839-2296

Other practice location 2

1850 N Central Ave Ste 1600
Phoenix, AZ 85004-4633
Phone (602) 262-8917

Other practice location 3

1111 E McDowell Rd
LL2
Phoenix, AZ 85006-2612
Phone (602) 839-2296

Other identifiers 1

IdentifierTypeStateIssuer
284088MedicaidAZ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170815004315 AZ Practitioner - Anesthesiology 3072885797 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47520AZMDAnesthesiology Physician
R73384AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Mar 15, 2022 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Dec 1, 2023 Accepting new patients
District Medical Group, Inc CurrentSince Mar 15, 2022 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
District Medical Group, Inc Current Accepting new patients
Phoenix Children's Medical Group CurrentSince Dec 1, 2022 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Dec 1, 2023 Accepting new patients
Phoenix Children's Hospital CurrentSince Dec 1, 2022 Accepting new patients
Phoenix Children's Hospital Past Accepting new patients

Locations

3370 S Mercy Rd
Ste 112
Gilbert, AZ 85297

19007 N 67th Ave
Glendale, AZ 85308
Phone (602) 933-0777

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1111 E McDowell Rd
#2
Phoenix, AZ 85006
Phone (602) 839-2206

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

1625 N Campbell Ave
Tucson, AZ 85719

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/75620b41-1ac4-4c73-abd7-1415dc6810c3/

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1720349095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-4660",
            "fax_number": "602-933-8945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 E McDowell Rd",
            "address_2": "LL2",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062612",
            "country_code": "US",
            "telephone_number": "602-839-2296",
            "fax_number": "602-839-2084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 N Central Ave Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850044633",
            "country_code": "US",
            "telephone_number": "602-262-8917",
            "fax_number": "602-262-8890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 E McDowell Rd",
            "address_2": "LL2",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062612",
            "country_code": "US",
            "telephone_number": "602-839-2296",
            "fax_number": "602-839-2084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOWNSEND",
        "first_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "47520",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R73384",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "AZ",
            "license": "47520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284088",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.