Individual provider Active NPI

Alena Thompson, FNP-C

  • Family Nurse Practitioner
  • Springerville, AZ
National Provider Identifier
1104206879
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10558 Issued in AZ
Practice address
118 S Mountain Ave
Springerville, AZ 85938-5104
Phone
(928) 333-7333
Fax
(928) 333-7157
NPI assigned
Jun 8, 2015
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 AP10558 AZ Primary

Addresses

Primary practice location

118 S Mountain Ave
Springerville, AZ 85938-5104

Mailing address

118 S Mountain Ave
Springerville, AZ 85938-5104
Phone (928) 333-7333

Other identifiers 2

IdentifierTypeStateIssuer
RN210400OtherAZARIZONA STATE BOARD OF NURSING RN NUMBER
AP10558OtherAZARIZONA STATE BOARD OF NURSING NP NUMBER

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP10558AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tall Pines Wellness Current Accepting new patients
Tia Arizona LLC Past Accepting new patients

Organizations & group practices 2

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104206879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S MOUNTAIN AVE",
            "city": "SPRINGERVILLE",
            "state": "AZ",
            "postal_code": "859385104",
            "telephone_number": "928-333-7333",
            "fax_number": "928-333-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S MOUNTAIN AVE",
            "city": "SPRINGERVILLE",
            "state": "AZ",
            "postal_code": "859385104",
            "telephone_number": "928-333-7333",
            "fax_number": "928-333-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ALENA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE BOARD OF NURSING RN NUMBER",
            "identifier": "RN210400",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE BOARD OF NURSING NP NUMBER",
            "identifier": "AP10558",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springerville, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.