Individual provider Active NPI

Gladys M O'Connor, NP-C

  • Family Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1821807744
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
217204 Issued in AZ
Practice address
2485 N 160TH Ave
Goodyear, AZ 85395-7601
Phone
(707) 624-6134
NPI assigned
Jan 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 217204 AZ Primary

Addresses

Primary practice location

2485 N 160TH Ave
Goodyear, AZ 85395-7601

Mailing address

2485 N 160TH Ave
Goodyear, AZ 85395-7601
Phone (707) 624-6134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250630002888 AZ Practitioner - Nurse Practitioner 1355854605 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
217204AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pophealthcare Medical Services of Az, PC CurrentSince Aug 4, 2024 Accepting new patients
Pophealthcare Medical Services of Az, PC Family CurrentSince May 12, 2025 Accepting new patients
Arizona Advanced Surgery LLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

4915 E Baseline Rd
Ste 104
Gilbert, AZ 85234
Phone (480) 292-8542

7205 S 51st Ave
Ste 203
Laveen, AZ 85339
Phone (602) 358-7073

1450 S Dobson Rd
Ste B122
Mesa, AZ 85202
Phone (480) 580-2001

1012 E Willetta St
Phoenix, AZ 85006
Phone (602) 239-6040

3811 E Bell Rd
Ste 103
Phoenix, AZ 85032
Phone (480) 569-2729

1438 W Broadway Rd
Ste 101
Tempe, AZ 85282
Phone (480) 524-1600

2141 E Broadway Rd
Ste 120
Tempe, AZ 85282
Phone (480) 237-5098

113 Seaboard Ln
Ste 200B
Franklin, TN 37067
Phone (615) 721-7020

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGJBCD

Organizations & group practices 3

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": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1821807744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 N 160TH AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957601",
            "telephone_number": "707-624-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 N 160TH AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957601",
            "telephone_number": "707-624-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "GLADYS",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "217204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.