Provider Demographics
NPI:1841631330
Name:RHODES, MATTHEW MICHAEL (FNP)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MICHAEL
Last Name:RHODES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:MATTHEW
Other - Middle Name:MICHAEL
Other - Last Name:PARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:3260 N HAYDEN RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6651
Mailing Address - Country:US
Mailing Address - Phone:480-542-5590
Mailing Address - Fax:480-542-5591
Practice Address - Street 1:2504 S RURAL RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2429
Practice Address - Country:US
Practice Address - Phone:480-542-5590
Practice Address - Fax:480-542-5591
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN198428163WE0003X, 163WP0000X
AZAP8585363LF0000X, 363LP2300X, 363L00000X, 363LX0106X, 363LP2300X
CANPF23341363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ175129Medicaid