Individual provider Active NPI

Tanya O Weatherby, NP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1053893693
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11683 Issued in AZ
Practice address
8050 E Lakeside Pkwy
Tucson, AZ 85730-1254
Phone
(520) 584-5820
Fax
(520) 514-1514
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP11683 AZ Primary

Addresses

Primary practice location

8050 E Lakeside Pkwy
Tucson, AZ 85730-1254

Mailing address

1477 W Commerce CT
Tucson, AZ 85746-6016
Phone (520) 792-3293

Other practice location 1

1512 N Paseo La Tinaja
Green Valley, AZ 85614
Phone (520) 490-5409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240523001781 AZ Order and Referring Only - Nurse Practitioner 5294069480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP11683AZMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1053893693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 W COMMERCE CT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857466016",
            "telephone_number": "520-792-3293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 E LAKESIDE PKWY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857301254",
            "telephone_number": "520-584-5820",
            "fax_number": "520-514-1514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1512 N Paseo La Tinaja",
            "address_purpose": "LOCATION",
            "city": "Green Valley",
            "state": "AZ",
            "postal_code": "85614",
            "country_code": "US",
            "telephone_number": "520-490-5409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEATHERBY",
        "first_name": "TANYA",
        "middle_name": "O",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.