Active NPI
Deirdre Patricia Mountjoy, NP
- Nurse Practitioner
- Gilbert, AZ
National Provider Identifier
1730262874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN079805
- Practice address
- 2680 S Val Vista Dr
BLDG 13 Unit 175
Gilbert, AZ 85295-2152 - Phone
- (480) 784-0110
- Fax
- (480) 784-0220
- NPI assigned
- Oct 23, 2006
- Last updated
- Aug 28, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN079805 | AZ | Primary |
Addresses
Primary practice location
2680 S Val Vista Dr
BLDG 13 Unit 175
Gilbert, AZ 85295-2152
Mailing address
2680 S Val Vista Dr
BLDG 13 Unit 175
Gilbert, AZ 85295-2152
Phone (480) 784-0110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 176851 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN079805 | AZ | MD | Diabetes Educator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner -- University Primary Care Physicians LLC | Past | Accepting new patients | |
| Desert Valley ENT, PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Primary Care Clinic/Center
- Payson, AZ
- NPI 1154791960
-
- Otolaryngology Physician
- Gilbert, AZ
- NPI 1184713430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1730262874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2680 S VAL VISTA DR",
"address_2": "BLDG 13 UNIT 175",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852952152",
"telephone_number": "480-784-0110",
"fax_number": "480-784-0220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2680 S VAL VISTA DR",
"address_2": "BLDG 13 UNIT 175",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852952152",
"telephone_number": "480-784-0110",
"fax_number": "480-784-0220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUNTJOY",
"first_name": "DEIRDRE",
"middle_name": "PATRICIA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "RN079805",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "176851",
"state": "AZ"
}
],
"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 Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.