Individual provider Active NPI

Lorraine K Merrill

  • Pediatric Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1144832874
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RNP304009 Issued in AZ
Practice address
535 N Wilmot Rd Ste 101
Tucson, AZ 85711-2683
Phone
(520) 694-8888
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X RN128057 AZ
Pediatric Nurse Practitioner 363LP0200X RNP304009 AZ Primary

Addresses

Primary practice location

535 N Wilmot Rd Ste 101
Tucson, AZ 85711-2683

Mailing address

PO Box 806
Saint David, AZ 85630-0806
Phone (928) 243-2383

Other practice location 1

124 E Thomas
Saint David, AZ 85630
Phone (928) 243-2383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326002214 AZ Practitioner - Nurse Practitioner 1658718614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RNP304009AZMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Mar 1, 2024 Accepting new patients
Banner-University Medical Group CurrentSince Mar 1, 2024 Accepting new patients

Locations

6261 N La Cholla Blvd
Ste 131
Tucson, AZ 85741
Phone (301) 984-1979

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

8290 S Houghton Rd
Ste 150
Tucson, AZ 85747
Phone (520) 694-1045

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

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": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1144832874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 806",
            "city": "SAINT DAVID",
            "state": "AZ",
            "postal_code": "856300806",
            "telephone_number": "928-243-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 N WILMOT RD STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112683",
            "telephone_number": "520-694-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 E Thomas",
            "address_purpose": "LOCATION",
            "city": "Saint David",
            "state": "AZ",
            "postal_code": "85630",
            "country_code": "US",
            "telephone_number": "928-243-2383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "LORRAINE",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "AZ",
            "license": "RN128057",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "RNP304009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.