Active NPI
Andrea Carol Pena, R.T. (R)
- Radiologic Technologist
- Parker, AZ
National Provider Identifier
1033546932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 13424
- Practice address
- 12033 Agency Rd
Parker, AZ 85344-7718 - Phone
- (928) 669-3380
- Fax
- (928) 669-3377
- NPI assigned
- Oct 9, 2013
- 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 |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 13424 | AZ | Primary |
Addresses
Primary practice location
12033 Agency Rd
Parker, AZ 85344-7718
Mailing address
12033 Agency Rd
Parker, AZ 85344-7718
Phone (928) 669-3380
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13424 | AZ | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381276800000",
"number": "1033546932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12033 AGENCY RD",
"city": "PARKER",
"state": "AZ",
"postal_code": "853447718",
"telephone_number": "928-669-3380",
"fax_number": "928-669-3377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12033 AGENCY RD",
"city": "PARKER",
"state": "AZ",
"postal_code": "853447718",
"telephone_number": "928-669-3380",
"fax_number": "928-669-3377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "ANDREA",
"middle_name": "CAROL",
"name_prefix": "Mrs.",
"credential": "R.T. (R)",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-09",
"last_updated": "2013-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "AZ",
"license": "13424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parker, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.