Active NPI
Jimmy Nealy
- Counselor
- Tucson, AZ
National Provider Identifier
1154807113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- BH5419
- Practice address
- 3310 N El Burrito Ave
Tucson, AZ 85705-3404 - Phone
- (520) 300-4976
- NPI assigned
- Jul 12, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | BH5419 | AZ | Primary |
Addresses
Primary practice location
3310 N El Burrito Ave
Tucson, AZ 85705-3404
Mailing address
3310 N El Burrito Ave
Tucson, AZ 85705-3404
Phone (520) 300-4976
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH5419 | AZ | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peoples Health Care Connection, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Casa De Sonrisa
- Mental Health Counselor
- Tucson, AZ
- NPI 1134605041
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1154807113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3310 N EL BURRITO AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857053404",
"telephone_number": "520-300-4976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3310 N EL BURRITO AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857053404",
"telephone_number": "520-300-4976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEALY",
"first_name": "JIMMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-12",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": "AZ",
"license": "BH5419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.