Individual provider Active NPI

Vinitha Nair, APN-CNP

  • Occupational Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1740563246
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health Nurse PractitionerTaxonomy code 363LX0106X
License
274807 Issued in AZ
Practice address
1300 N 12TH St Ste 520
Phoenix, AZ 85006-2849
Phone
(602) 255-7520
Fax
(602) 255-7530
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209009069 IL
Occupational Health Nurse Practitioner 363LX0106X 274807 AZ Primary

Addresses

Primary practice location

1300 N 12TH St Ste 520
Phoenix, AZ 85006-2849

Mailing address

2150 Pfingsten Rd
Glenview, IL 60026-1361
Phone (847) 657-1700

Other practice location 1

2150 Pfingsten Rd
Glenview, IL 60026-1361
Phone (847) 657-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20111105000040 IL Practitioner - Nurse Practitioner 3476726548 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
274807AZMDOccupational Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Apr 11, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 11, 2021 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 4225
Evanston, IL 60201
Phone (847) 570-1060

2150 Pfingsten Rd
Glenview, IL 60026
Phone (847) 486-6550

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1740563246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PFINGSTEN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261361",
            "telephone_number": "847-657-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 520",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062849",
            "telephone_number": "602-255-7520",
            "fax_number": "602-255-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Pfingsten Rd",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261361",
            "country_code": "US",
            "telephone_number": "847-657-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAIR",
        "first_name": "VINITHA",
        "credential": "APN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009069",
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "AZ",
            "license": "274807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.