MRS. MARY ELLEN KENWORTHEY NP NPI 1184603342

NPI Information

NPI: 1184603342
Provider Name: MRS. MARY ELLEN KENWORTHEY, NP
Classification: Nurse Practitioner - 363LX0001X
Entity Type: Individual

Specialization: Obstetrics & Gynecology

PECOS Registration: Yes

Address:
2929 E THOMAS RD
PHOENIX, AZ
ZIP 85016
Phone: (602) 470-5000
Get Directions

MRS. Mary Ellen Kenworthey, NP is an obstetrics and gynecology nurse practitioner in Phoenix, AZ. MRS. Mary Ellen Kenworthey, NP NPI is 1184603342. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2929 E THOMAS RD
PHOENIX, AZ
ZIP 85016-034
Phone: (602) 470-5000

The NPI 1184603342 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/15/2006 and was last updated on 3/10/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health	RN043733	ARIZONA	No
2	363LW0102X	Nurse Practitioner	Women's Health	AP0078	ARIZONA	No
3	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	RN043733	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	Z181809	MEDICARE PIN	ARIZONA
2	S85932	MEDICARE UPIN	ARIZONA
3	Z135053	MEDICARE PIN
4	760406	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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