Individual provider Active NPI

Uduakobong Columbus Dyer, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1841833779
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
233409 Issued in AZ
Practice address
401 E Bell Rd Ste 18
Phoenix, AZ 85022-2395
Phone
(480) 677-8282
Fax
(844) 470-2777
NPI assigned
Oct 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 233409 AZ Primary

Addresses

Primary practice location

401 E Bell Rd Ste 18
Phoenix, AZ 85022-2395

Mailing address

261 N Roosevelt Ave
Chandler, AZ 85226-2617
Phone (480) 677-8282

Other identifiers 1

IdentifierTypeStateIssuer
079412MedicaidAZ

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
I20200810002045 AZ Practitioner - Nurse Practitioner 6800211798 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233409AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Single Specialty CurrentSince Sep 23, 2021 Accepting new patients
Good Health Medical, PLLC CurrentSince Aug 12, 2024 Accepting new patients
Good Health Medical, PLLC Single Specialty Current Accepting new patients
Good Health Medical, PLLC CurrentSince Aug 12, 2024 Accepting new patients
Equality Health at Home Inc Single Specialty Past Accepting new patients

Locations

28138 N Tatum Blvd
Cave Creek, AZ 85331
Phone (480) 585-6097

261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

765 S Lindsay Rd
Gilbert, AZ 85296
Phone (480) 635-0113

2640 W Baseline Rd
Ste 111
Phoenix, AZ 85041
Phone 4803052888 ext. 1109

401 E Bell Rd
Ste 18
Phoenix, AZ 85022
Phone (602) 368-1403

1703 W Bethany Home Rd
Ste E27
Phoenix, AZ 85015

1610 E Camelback Rd
Phoenix, AZ 85016
Phone (602) 277-1727

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

10650 N Oracle Rd
Tucson, AZ 85737
Phone (520) 544-5544

Interoperability endpoints

  • Direct secure messaging: udyer26649@mydrnow.gardenplot.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1841833779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N ROOSEVELT AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262617",
            "telephone_number": "480-677-8282",
            "fax_number": "844-470-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E BELL RD STE 18",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850222395",
            "telephone_number": "480-677-8282",
            "fax_number": "844-470-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "UDUAKOBONG",
        "middle_name": "COLUMBUS",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "233409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079412",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.