Individual provider Active NPI

L Stephen Nunn, PA

  • Medical Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1114917192
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1074 Issued in AZ
Practice address
5410 N Scottsdale Rd
Suite B 200
Scottsdale, AZ 85253-5927
Phone
(480) 866-3151
Fax
(480) 991-8395
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1074 AZ Primary

Addresses

Primary practice location

5410 N Scottsdale Rd
Suite B 200
Scottsdale, AZ 85253-5927

Mailing address

8412 E Shea Blvd
Suite 101
Scottsdale, AZ 85260-6664
Phone (480) 874-1515

Other identifiers 1

IdentifierTypeStateIssuer
497520MedicaidAZ

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.
Opted out of Medicare
Yes, effective Oct 1, 2014 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1074AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gino Tutera MD, a Professional Corporation Past Accepting new patients
Tutera Medical Inc PastSince Oct 21, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1114917192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8412 E SHEA BLVD",
            "address_2": "SUITE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606664",
            "telephone_number": "480-874-1515",
            "fax_number": "480-991-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 N SCOTTSDALE RD",
            "address_2": "SUITE B 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852535927",
            "telephone_number": "480-866-3151",
            "fax_number": "480-991-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNN",
        "first_name": "L STEPHEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "1074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497520",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.