Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1588322770 Individual Practitioner Female Practitioner

Ilyssa Bain , PNP-AC

Nurse Practitioner - Pediatrics • Phoenix, AZ

Professional Overview & Biography Verified Profile Summary

Ilyssa Bain, PNP-AC is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Phoenix, AZ. Practice services are available at 1919 E THOMAS RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1919 E Thomas Rd

Phoenix, AZ 850167710

Telephone 6029331900
Associated Practice Facility / Clinic
🏢 Phoenix Children's Hospital Facility NPI 1760480503

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Phoenix, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.8 Yrs
State Avg: 11.9 Yrs
Regional Practice Density
244 Specialists

Practicing in Phoenix, AZ (443 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-02-22
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License AZ 259452

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
120424 (AZ)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003341223

Doctor of Medicine (M.D.)

Kyle Christian-Dold , CPNP

Nurse Practitioner - Pediatrics

NPI 1003436288

Certified Pediatric Nurse Practitioner

NPI 1023100930

Doctor of Medicine (M.D.)

Cherisse Mecham

Pediatrics - Pediatric Emergency Medicine

NPI 1043639792
Olivia Meier

Nurse Practitioner - Pediatrics

NPI 1043954985
Peter Mcgerty

Physician Assistant

NPI 1083086557

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 22, 2024

Nurse Practitioner (License #259452 in AZ)

📍
Updated Business Mailing Address November 17, 2022

Registered at 2108 E THOMAS RD STE 130, PHOENIX, AZ 850167761 (Tel: 6029331813)

NPI Profile Active December 04, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location December 04, 2021

Registered at 1919 E THOMAS RD, PHOENIX, AZ 850167710 (Tel: 2034489378)

📍
Updated Business Mailing Address December 04, 2021

Registered at 2777 S ARIZONA AVE APT 3170, CHANDLER, AZ 852861823 (Tel: 2034489378)

👤
Provider Name / Credentials Updated December 04, 2021

Recorded as ILYSSA BAIN, PNP-AC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 04, 2021

Nurse Practitioner (License #259452 in AZ)

🟢
Initial NPI Registration & Enumeration December 04, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588322770
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 04, 2021
Last Update: February 22, 2024
Sole Proprietor: No

Mailing Address

2108 E Thomas Rd Ste 130

Phoenix, AZ 850167761

Phone: 6029331813

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.