Active NPI
Tigger R Mathis, MSN,APN,FNP
- Family Nurse Practitioner
- Glendale, AZ
National Provider Identifier
1083927420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP11324
- Practice address
- 6611 W Peoria Ave
Glendale, AZ 85302-7000 - Phone
- (602) 325-5580
- NPI assigned
- Jul 14, 2010
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP11324 | AZ | Primary |
Addresses
Primary practice location
6611 W Peoria Ave
Glendale, AZ 85302-7000
Mailing address
6611 W Peoria Ave
Glendale, AZ 85302-7000
Phone (602) 325-5580
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| V115416 | Other | NV | SMA MEDICARE |
| 1083927420 | Medicaid | NV |
Other names 1
- Tigger R Laird
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
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP11324 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians Medical Center Kaufman, LTD | Past | Accepting new patients | |
| Iora Health Massachusetts, P.C. | Past | Accepting new patients | |
| Iora Health, LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586390400000",
"number": "1083927420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6611 W PEORIA AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853027000",
"telephone_number": "602-325-5580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6611 W PEORIA AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853027000",
"telephone_number": "602-325-5580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "TIGGER",
"middle_name": "R",
"credential": "MSN,APN,FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-14",
"last_updated": "2020-04-09",
"certification_date": "2020-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP11324",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SMA MEDICARE",
"identifier": "V115416",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1083927420",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TIGGER",
"last_name": "LAIRD",
"middle_name": "R",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.