Organization Active NPI

Tribe Wellness Group PLLC

  • Neurology Physician
  • Cottonwood, AZ
National Provider Identifier
1073004339
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
TRIBE WELLNESS GROUP PLLC
Practice address
549 S Main St
Cottonwood, AZ 86326-3902
Phone
(928) 202-9187
Fax
(928) 202-4666
NPI assigned
May 22, 2018
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Kelly Weathersby
Title
Office Manager
Phone
(928) 202-9187

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

549 S Main St
Cottonwood, AZ 86326-3902

Mailing address

549 S Main St
Cottonwood, AZ 86326-3902
Phone (928) 202-9187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180824002709 AZ Part B Supplier - Clinic/Group Practice 0244589174 Receives reassigned benefits from 2 practitioners
Practice locations: Cottonwood, AZ; Sedona, AZ

National Provider Directory

National Provider Directory

Locations

549 S Main St
Cottonwood, AZ 86326
Phone (928) 202-9187

1835 W State Route 89A
Ste 2
Sedona, AZ 86336
Phone (928) 202-9187

2030 W State Route 89A
Ste B4
Sedona, AZ 86336
Phone (928) 202-9187

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1073004339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 S MAIN ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263902",
            "telephone_number": "928-202-9187",
            "fax_number": "928-202-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 S MAIN ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263902",
            "telephone_number": "928-202-9187",
            "fax_number": "928-202-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIBE WELLNESS GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-22",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "WEATHERSBY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-202-9187"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.