NPIMap

Individual provider Active NPI

David Alan Eisenbise, DNP, FNP-BC

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1962858951
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP8593 Issued in AZ
Practice address
17218 N 72ND Dr Ste 100
Glendale, AZ 85308-8581
Phone
(623) 334-8671
Fax
(623) 334-8675
NPI assigned
May 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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 AP8593 AZ Primary

Addresses

Primary practice location

17218 N 72ND Dr Ste 100
Glendale, AZ 85308-8581

Mailing address

17218 N. 72ND Dr. Suite 100,
Apt B209
Glendale, AZ 85308-9698
Phone (623) 334-8671

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona State University Past Accepting new patients
Arizona State University Past Accepting new patients

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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1962858951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17218 N. 72ND DR. SUITE 100,",
            "address_2": "APT B209",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853089698",
            "telephone_number": "623-334-8671",
            "fax_number": "623-334-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17218 N 72ND DR STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088581",
            "telephone_number": "623-334-8671",
            "fax_number": "623-334-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBISE",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.