Active NPI
Audrey W Tuberville, M.D.
- Specialist
- Tucson, AZ
National Provider Identifier
1003967142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 35431
- Practice address
- 3601 S 6TH St
Eye Clinic
Tucson, AZ 85723 - Phone
- (520) 792-1450
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 35431 | AZ | Primary |
Addresses
Primary practice location
3601 S 6TH St
Eye Clinic
Tucson, AZ 85723
Mailing address
4560 N Flecha Dr
Tucson, AZ 85718-6726
Phone (520) 529-2361
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3187169 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35431 | AZ | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271116800000",
"number": "1003967142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 N FLECHA DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857186726",
"telephone_number": "520-529-2361",
"fax_number": "520-577-0934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 S 6TH ST",
"address_2": "EYE CLINIC",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85723",
"telephone_number": "520-792-1450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUBERVILLE",
"first_name": "AUDREY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2010-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AZ",
"license": "35431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3187169",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.