Individual provider Active NPI

Claudia Georgeta Damanhuri

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1891573762
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022059638 Issued in AZ
Practice address
8726 N 53Rd Ave
Glendale, AZ 85302-4809
Phone
(602) 810-7317
NPI assigned
Sep 20, 2023
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 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 2022059638 AZ Primary

Addresses

Primary practice location

8726 N 53Rd Ave
Glendale, AZ 85302-4809

Mailing address

8726 N 53Rd Ave
Glendale, AZ 85302-4809
Phone (602) 810-7317

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
I20240315001912 AZ Practitioner - Nurse Practitioner 8729424452 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8726 N 53Rd Ave
Glendale, AZ 85302-4809
Phone (602) 810-7317

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022059638AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amble Medical Family CurrentSince Apr 15, 2024 Accepting new patients
Global Wound Care Medical Group CurrentSince Jan 31, 2024 Accepting new patients
Acuity Wound Care Family CurrentSince Apr 1, 2025 Accepting new patients
Blooming Health Services CurrentSince Jun 3, 2024 Accepting new patients
Amble Medical CurrentSince Apr 15, 2024 Accepting new patients

Locations

3651 E Baseline Rd
Ste E230
Gilbert, AZ 85234
Phone (602) 633-9568

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

9980 S 300 W
Ste 310
Sandy, UT 84070
Phone 8012536886300

1460 N Main St
Unit 1B
Spanish Fork, UT 84660
Phone (801) 318-8930

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1891573762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8726 N 53RD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853024809",
            "telephone_number": "602-810-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8726 N 53RD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853024809",
            "telephone_number": "602-810-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMANHURI",
        "first_name": "CLAUDIA",
        "middle_name": "GEORGETA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "2022059638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.