Individual provider Active NPI

Christine Ashley Coombs, NP

  • Nurse Practitioner
  • Surprise, AZ
National Provider Identifier
1841015278
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN212636 Issued in AZ
Practice address
15543 N Reems Rd Ste 139
Surprise, AZ 85374-9582
Phone
(623) 826-2114
NPI assigned
Nov 20, 2024
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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 RN212636 AZ Primary

Addresses

Primary practice location

15543 N Reems Rd Ste 139
Surprise, AZ 85374-9582

Mailing address

15543 N Reems Rd Ste 139
Surprise, AZ 85374-9582

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
I20241210003486 AZ Practitioner - Nurse Practitioner 2466988761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Medical Center, LLCGroup PAC ID 4082029707, 3 clinicians

Practice addresses (Care Compare)

17250 N 43Rd Ave
Suite 5
Glendale, AZ 85308-4037
Phone (623) 842-1261

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Medical Center, LLC CurrentSince Jan 6, 2025 Accepting new patients
Corner Health Medical Group P a PastSince Nov 24, 2024 Accepting new patients
Advanced Technology Chiropractic LLC PastSince Jan 6, 2025 Accepting new patients

Locations

17250 N 43rd Ave
Ste 5
Glendale, AZ 85308
Phone (623) 842-1261

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1841015278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15543 N REEMS RD STE 139",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853749582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15543 N REEMS RD STE 139",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853749582",
            "telephone_number": "623-826-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMBS",
        "first_name": "CHRISTINE",
        "middle_name": "ASHLEY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "RN212636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.