Individual provider Active NPI

Whitney Elizabeth Branham

  • Student in an Organized Health Care Education/Training Program
  • Glendale, AZ
National Provider Identifier
1730964164
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
19555 N 59TH Ave
Glendale, AZ 85308-6813
Phone
(623) 572-3200
NPI assigned
Aug 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ Primary

Addresses

Primary practice location

19555 N 59TH Ave
Glendale, AZ 85308-6813

Mailing address

19555 N 59TH Ave
Glendale, AZ 85308-6813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813004461 WA Order and Referring Only - PodiatryPractitioner - Podiatry 8426596081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1730964164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19555 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19555 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086813",
            "telephone_number": "623-572-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANHAM",
        "first_name": "WHITNEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.