Individual provider Active NPI

Brittany Ibanez, LPN

  • Licensed Practical Nurse
  • Tempe, AZ
National Provider Identifier
1851839179
Registry record updated Feb 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
252715 Issued in AZ
Practice address
4041 S McClintock Dr Ste 302
Tempe, AZ 85282-5879
Phone
(480) 339-1780
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN 686576 CA
Licensed Practical Nurse 164W00000X 252715 AZ Primary

Addresses

Primary practice location

4041 S McClintock Dr Ste 302
Tempe, AZ 85282-5879

Mailing address

4041 S McClintock Dr Ste 302
Tempe, AZ 85282-5879
Phone (480) 339-1780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
252715AZMDLicensed Practical Nurse
VN 686576CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Adobe Provider Group CurrentSince Feb 24, 2022 Accepting new patients
Adobe Care and Wellness LLC PastSince Feb 24, 2022 Accepting new patients

Locations

4041 S McClintock Dr
Ste 302
Tempe, AZ 85282
Phone (520) 233-7111

Organizations & group practices 2

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": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644710400000",
    "number": "1851839179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 S MCCLINTOCK DR STE 302",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825879",
            "telephone_number": "480-339-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 S MCCLINTOCK DR STE 302",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825879",
            "telephone_number": "480-339-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBANEZ",
        "first_name": "BRITTANY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2022-02-13",
        "certification_date": "2022-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN 686576",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "252715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.