Active NPI
Tiffany A Lunt, M.D.
- Family Medicine Physician
- Prescott, AZ
National Provider Identifier
1063492346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 36387
- Practice address
- 1050 Gail Gardner Way Ste 100
Prescott, AZ 86305-1631 - Phone
- (928) 777-0700
- Fax
- (928) 778-5507
- NPI assigned
- Jan 20, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | N4561 | TX | |
| Family Medicine Physician | 207Q00000X | 36387 | AZ | Primary |
Addresses
Primary practice location
1050 Gail Gardner Way Ste 100
Prescott, AZ 86305-1631
Mailing address
PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 777-0700
Other practice location 1
980 Willow Creek Rd
Prescott, AZ 86301-1611
Phone (928) 777-0700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108878 | Medicaid | AZ | |
| 36387 | Other | AZ | AZ LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36387 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1063492346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10880",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863040880",
"telephone_number": "928-777-0700",
"fax_number": "928-778-5507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 GAIL GARDNER WAY STE 100",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863051631",
"telephone_number": "928-777-0700",
"fax_number": "928-778-5507"
}
],
"practiceLocations": [
{
"address_1": "980 Willow Creek Rd",
"address_purpose": "LOCATION",
"city": "Prescott",
"state": "AZ",
"postal_code": "863011611",
"country_code": "US",
"telephone_number": "928-777-0700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUNT",
"first_name": "TIFFANY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "N4561",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "36387",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108878",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ LICENSE",
"identifier": "36387",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.