Individual provider Active NPI

Tabetha J Perry, MSN, FNP-BC

  • Family Nurse Practitioner
  • Sierra Vista, AZ
National Provider Identifier
1114888559
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
271528 Issued in SC
Practice address
2250 El Mercado Loop
Sierra Vista, AZ 85635-5204
Phone
(520) 220-5020
NPI assigned
Nov 24, 2025
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 271528 SC Primary
Family Nurse Practitioner 363LF0000X 333582 AZ

Addresses

Primary practice location

2250 El Mercado Loop
Sierra Vista, AZ 85635-5204

Mailing address

4965 E Ironwood Cir
Sierra Vista, AZ 85650-5344
Phone (423) 502-1072

Other names 1

  • Tabetha J Kramer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
333582AZMDFamily Nurse Practitioner
271528SCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1114888559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 E IRONWOOD CIR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856505344",
            "telephone_number": "423-502-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 EL MERCADO LOOP",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856355204",
            "telephone_number": "520-220-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "TABETHA",
        "middle_name": "J",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-24",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "271528",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "333582",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABETHA",
            "last_name": "KRAMER",
            "middle_name": "J",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.