Individual provider Active NPI

Rachael Ann Kimes, NP

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1982780474
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP2560 Issued in AZ
Practice address
8041 N Black Canyon Hwy
Phoenix, AZ 85021-4876
Phone
(602) 249-0115
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN124138 AZ
Acute Care Nurse Practitioner 363LA2100X AP2560 AZ Primary

Addresses

Primary practice location

8041 N Black Canyon Hwy
Phoenix, AZ 85021-4876

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

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
I20070115000314 AZ Practitioner - Nurse Practitioner 1951301043 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN124138AZMDRegistered Nurse
AP2560AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC CurrentSince Oct 22, 2017 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Oct 22, 2017 Accepting new patients
Social Work Associates LLC CurrentSince Feb 27, 2015 Accepting new patients
Total Orthopedics,LLC Past Accepting new patients

Locations

8041 N Black Canyon Hwy
Ste I
Phoenix, AZ 85021

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

8041 N Black Canyon Hwy
Phoenix, AZ 85021
Phone (602) 249-0115

7014 E Camelback Rd
#B10089
Scottsdale, AZ 85251
Phone (480) 568-4599

Organizations & group practices 4

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1982780474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8041 N BLACK CANYON HWY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214876",
            "telephone_number": "602-249-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMES",
        "first_name": "RACHAEL",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN124138",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP2560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.