Individual provider Active NPI

Theresa M Rimer, NP

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1821034521
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
054596 Issued in AZ
Practice address
3600 N 3Rd Ave
Phoenix, AZ 85013-3904
Phone
(602) 406-3543
Fax
(602) 406-6135
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 054596 AZ Primary

Addresses

Primary practice location

3600 N 3Rd Ave
Phoenix, AZ 85013-3904

Mailing address

3200 N Central Ave
9TH Floor
Phoenix, AZ 85012-2425
Phone (602) 406-3729

Other identifiers 1

IdentifierTypeStateIssuer
937039MedicaidAZ

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

LicenseStateTypeSpecialty
054596AZMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1821034521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 N CENTRAL AVE",
            "address_2": "9TH FLOOR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122425",
            "telephone_number": "602-406-3729",
            "fax_number": "602-798-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 N 3RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133904",
            "telephone_number": "602-406-3543",
            "fax_number": "602-406-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIMER",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "054596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "937039",
            "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 9, 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.

Verify at the official NPI Registry.