Renee Jeanine Privett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2700 Issued in AZ

Practice address

2121 W Chandler Blvd
Ste 110
Chandler, AZ 85224-6545

Phone

(480) 963-2233

Fax

(480) 963-2277

NPI assigned

Jan 27, 2009

Last updated

Nov 24, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: renee.privett@ospi.directbygreenway.com

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.

• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun Lakes, AZ
  • NPI 1285295089
  NPD
• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucson, AZ
  • NPI 1609662709
  NPD
• St. Joseph's Hospital and Medical Center

  dba SJHMC Trauma Services

  • Emergency Care Clinic/Center
  • Phoenix, AZ
  • NPI 1255382412
  NPD

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1841438959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 W CHANDLER BLVD",
            "address_2": "STE 110",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246545",
            "telephone_number": "480-963-2233",
            "fax_number": "480-963-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W CHANDLER BLVD",
            "address_2": "STE 110",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246545",
            "telephone_number": "480-963-2233",
            "fax_number": "480-963-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIVETT",
        "first_name": "RENEE",
        "middle_name": "JEANINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2700",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2700",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "2700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3Z3974",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501958",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prime Surgical Assisting, LLC
• Danielle Davida Prince Rosenkrans, MD
• Sarah Prise
• Prism Hospice, LLC (Prism Hospice)
• Heather Pritchard, PHARM D
• Pro Edge, LLC (Compatible Home Care)
• Carol Jean Probert, M.S., PT
• Abigail J Prochaska, MT-BC
• Caitlyn E. Procopio, FNP-C
• John Proctor

• Physician Assistant in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.