Individual provider Active NPI

Chenille Stuckey, FNP

  • Family Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1871376863
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TEMP269125 Issued in AZ
Practice address
1325 N Litchfield Rd Ste 110
Goodyear, AZ 85395-1214
Phone
(623) 935-9494
Fax
(623) 935-9292
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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 Practitioner 363LF0000X TEMP269125 AZ Primary

Addresses

Primary practice location

1325 N Litchfield Rd Ste 110
Goodyear, AZ 85395-1214

Mailing address

1325 N Litchfield Rd Ste 110
Goodyear, AZ 85395-1214
Phone (623) 935-9494

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
I20230901002837 AZ Practitioner - Nurse Practitioner 5496118713 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monogram Health Professional Services PCGroup PAC ID 4880004183, 27 clinicians

Practice addresses (Care Compare)

Tempe, AZ 85281
Phone (855) 212-2273

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monogram Health Professional Services PC Nurse Practitioner CurrentSince Dec 10, 2024 Accepting new patients
Leading Healthcare, LLC CurrentSince Apr 1, 2024 Accepting new patients
Leading Healthcare Clinic of Goodyear LLC Family CurrentSince Nov 16, 2024 Accepting new patients
Med-Cure Internal Medicine, PLC CurrentSince Aug 18, 2023 Accepting new patients
Monogram Health Professional Services PC Nurse Practitioner CurrentSince Dec 10, 2024 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC PastSince Aug 18, 2023 Accepting new patients

Locations

525 S Watson Rd
Ste 205
Buckeye, AZ 85326
Phone (623) 344-0498

1325 N Litchfield Rd
Ste 110
Goodyear, AZ 85395
Phone (623) 932-4060

13657 W McDowell Rd
Ste 11
Goodyear, AZ 85395

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

13575 W McDowell Rd
Goodyear, AZ 85395
Phone (347) 309-3320

8035 E Brown Rd
Mesa, AZ 85207
Phone (480) 686-8540

13203 N 103rd Ave
Ste I5
Sun City, AZ 85351

60 E Rio Salado Pkwy
Ste 300
Tempe, AZ 85281

60 E Rio Salado Pkwy
Tempe, AZ 85281
Phone (480) 703-3743

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBDIAA
  • Direct secure messaging: chenille.stuckey.1@22854.direct.athenahealth.com

Organizations & group practices 6

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": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1871376863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 N LITCHFIELD RD STE 110",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951214",
            "telephone_number": "623-935-9494",
            "fax_number": "623-935-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 N LITCHFIELD RD STE 110",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951214",
            "telephone_number": "623-935-9494",
            "fax_number": "623-935-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "CHENILLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TEMP269125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.