KENZIE ELLSWORTH FNP-C
NPI 1487577383
Nurse Practitioner - Family in San Tan Valley, AZ
About Kenzie Ellsworth Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENZIE ELLSWORTH FNP-C (NPI 1487577383) is an individual family provider in San Tan Valley, Arizona, licensed in Arizona (235334) and active in the NPI registry since July 2026. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kenzie Ellsworth Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85140 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN TAN VALLEY, AZ 85140
SAN TAN VALLEY, AZ 85140
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenzie Ellsworth's NPI number?
The NPI number for Kenzie Ellsworth is 1487577383. It was assigned to this individual provider in the NPPES registry on July 30, 2026.
Where is Kenzie Ellsworth located?
Kenzie Ellsworth practices at 40773 N Ironwood Dr, San Tan Valley, AZ 85140. The listed phone number is (480) 684-5000.
What is Kenzie Ellsworth's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kenzie Ellsworth enrolled in Medicare?
Yes. Kenzie Ellsworth is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kenzie Ellsworth was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kenzie Ellsworth, FNP-C · NPI 1487577383
Family physician in San Tan Valley, Arizona. Individual provider, active in the CMS NPPES registry since July 30, 2026.
## Identity
- **NPI:** 1487577383 (Entity type: Individual)
- **Enumerated:** July 30, 2026
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 235334 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 40773 N IRONWOOD DR, San Tan Valley, AZ 85140-7002
- **Phone:** (480) 684-5000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1487577383) · Data from the CMS NPPES public registry.