Individual provider Active NPI

Brittnie C Abishalom, NP

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1841813748
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
241559 Issued in AZ
Practice address
6380 E Thomas Rd Ste 100
Scottsdale, AZ 85251-7033
Phone
(480) 607-0606
NPI assigned
May 26, 2020
Last updated
May 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2020

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 241559 AZ Primary

Addresses

Primary practice location

6380 E Thomas Rd Ste 100
Scottsdale, AZ 85251-7033

Mailing address

16331 N 73Rd Dr
Peoria, AZ 85382-1827
Phone (480) 795-9895

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
I20211019002814 AZ Practitioner - Nurse Practitioner 5597153841 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Livi Medical Services LLC CurrentSince May 31, 2020 Accepting new patients
Leading Health Managed Care, LLC CurrentSince Oct 1, 2021 Accepting new patients
Leading Healthcare Specialist PLLC CurrentSince Oct 1, 2021 Accepting new patients
Signify Health, LLC CurrentSince Jul 1, 2022 Accepting new patients
Leading Healthcare Clinic of Goodyear LLC Family CurrentSince Oct 1, 2021 Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

13555 W McDowell Rd
Ste 205
Goodyear, AZ 85395
Phone (623) 535-0740

6380 E Thomas Rd
Ste 100
Scottsdale, AZ 85251
Phone (480) 607-0606

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1841813748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16331 N 73RD DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853821827",
            "telephone_number": "480-795-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6380 E THOMAS RD STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517033",
            "telephone_number": "480-607-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABISHALOM",
        "first_name": "BRITTNIE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "241559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.