Active NPI
Russell Ortiz, NNP
- Neonatal Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1801816541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 51893
- Practice address
- 300 W Clarendon Ave
375
Phoenix, AZ 85013-3420 - Phone
- (602) 277-4161
- Fax
- (602) 274-3394
- NPI assigned
- Jul 19, 2006
- 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 |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 51893 | AZ | Primary |
Addresses
Primary practice location
300 W Clarendon Ave
375
Phoenix, AZ 85013-3420
Mailing address
300 W Clarendon Ave
375
Phoenix, AZ 85013-3420
Phone (602) 277-4161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105876 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51893 | AZ | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neonatology Associates, LTD | Neonatal | Past | Accepting new patients |
Organizations & group practices 1
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": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801816541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W CLARENDON AVE",
"address_2": "375",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850133420",
"telephone_number": "602-277-4161",
"fax_number": "602-274-3394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W CLARENDON AVE",
"address_2": "375",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850133420",
"telephone_number": "602-277-4161",
"fax_number": "602-274-3394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "RUSSELL",
"credential": "NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "AZ",
"license": "51893",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105876",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.