Individual provider Active NPI

Victoria Ann Tweedy, NP-C

  • Family Nurse Practitioner
  • Sun City, AZ
National Provider Identifier
1063712537
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP3850 Issued in AZ
Practice address
13203 N 103Rd Ave Ste H5
Sun City, AZ 85351-3032
Phone
(623) 777-4747
Fax
(623) 334-4400
NPI assigned
Oct 29, 2010
Last updated
May 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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 AP3850 AZ Primary

Addresses

Primary practice location

13203 N 103Rd Ave Ste H5
Sun City, AZ 85351-3032

Mailing address

13203 N 103Rd Ave
Ste H5
Sun City, AZ 85351-3032
Phone (623) 777-4747

Other identifiers 1

IdentifierTypeStateIssuer
570267MedicaidAZ

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
I20110527000372 AZ Practitioner - Nurse Practitioner 5395922462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novaspine Pain Institute PLCGroup PAC ID 9931323359, 20 clinicians

Practice addresses (Care Compare)

14300 W Granite Valley Dr
Suite A1
Sun City West, AZ 85375-5797
Phone (623) 777-4747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP3850AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novaspine Pain Institute, PLC CurrentSince Oct 22, 2018 Accepting new patients
Novaspine Pain Institute, PLC CurrentSince Oct 22, 2018 Accepting new patients
Laser Spine Institute of Arizona, LLC Past Accepting new patients
KM Healthcare LLC Family Past Accepting new patients
Next Level Facility LLC PastSince Nov 12, 2023 Accepting new patients

Locations

13203 N 103rd Ave
Ste H5
Sun City, AZ 85351
Phone 62377747474789

14300 W Granite Valley Dr
Ste A1
Sun City West, AZ 85375
Phone (602) 546-4934

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIBDAD/Endpoint/BIBDAD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1063712537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13203 N 103RD AVE",
            "address_2": "STE H5",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513032",
            "telephone_number": "623-777-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13203 N 103RD AVE STE H5",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513032",
            "telephone_number": "623-777-4747",
            "fax_number": "623-334-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWEEDY",
        "first_name": "VICTORIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-29",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "570267",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.