PHILIP C BRAUDT N.P. NPI 1003802521

Nurse Practitioner in Gold Canyon, AZ

Individual Male Nurse Practitioner

About PHILIP BRAUDT

Philip Braudt is a provider established in Gold Canyon, Arizona and his medical specialization is nurse practitioner. The NPI number of Philip Braudt is 1003802521 and was assigned on September 2005. The practitioner's primary taxonomy code is 363L00000X with license number RN102453 (AZ). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI

1003802521

Provider Name PHILIP C BRAUDT N.P.
Provider Location Address6820 S KINGS RANCH RD SUITE 130 GOLD CANYON, AZ 85118
Provider Mailing Address6820 S KINGS RANCH RD SUITE 130 GOLD CANYON, AZ 85118
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date09-20-2005
Last Update Date06-13-2012

Primary Taxonomy

Taxonomy Code363L00000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.RN102453
License StateAZ
Taxonomy Description(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Business Address

PHILIP C BRAUDT N.P.
6820 S KINGS RANCH RD
SUITE 130
GOLD CANYON, AZ
ZIP 85118
Phone: (480) 982-3691
Fax: (480) 982-3692

Get Directions

Mailing Address

PHILIP C BRAUDT N.P.
6820 S KINGS RANCH RD
SUITE 130
GOLD CANYON, AZ
ZIP 85118
Phone: (480) 982-3691
Fax: (480) 982-3692

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
951823MEDICAID (05)AZ

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1639538846STRIPES URGENT CARE, LLC
Organization
Clinic/Center (Urgent Care)6820 S KINGS RANCH RD SUITE 130
GOLD CANYON, AZ 85118
(480) 246-3411
1861899619GOLD CANYON URGENT CARE AND FAMILY MEDICINE
Organization
Physician Assistant (Medical)6820 S KINGS RANCH RD SUITE 130
GOLD CANYON, AZ 85118
(480) 982-3691
1952627663MR. RYAN WADE BROWER PA-C
Individual
Physician Assistant6820 S KINGS RANCH RD SUITE 130
GOLD CANYON, AZ 85118
(480) 982-3691

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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