Individual provider Active NPI

Tammy L Slade-Florez, NP

  • Family Nurse Practitioner
  • Yuma, AZ
National Provider Identifier
1174628283
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP0467 Issued in AZ
Practice address
1207 W 16TH St Ste B
Yuma, AZ 85364-4597
Phone
(928) 318-6910
Fax
(928) 328-1056
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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 AP0467 AZ Primary

Addresses

Primary practice location

1207 W 16TH St Ste B
Yuma, AZ 85364-4597

Mailing address

1207 W 16TH St Ste B
Yuma, AZ 85364-4597
Phone (928) 318-6910

Other identifiers 1

IdentifierTypeStateIssuer
342709MedicaidAZ

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
I20061207000197 AZ Practitioner - Nurse Practitioner 8426057167 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP0467AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry W. Florez Current Accepting new patients
BJD Inc Family CurrentSince Jan 23, 2021 Accepting new patients

Locations

1025 W 24th St
Ste 26
Yuma, AZ 85364
Phone (928) 318-6910

1207 W 16th St
Ste B
Yuma, AZ 85364
Phone (928) 318-6910

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1174628283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 W 16TH ST STE B",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644597",
            "telephone_number": "928-318-6910",
            "fax_number": "928-328-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 W 16TH ST STE B",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644597",
            "telephone_number": "928-318-6910",
            "fax_number": "928-328-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE-FLOREZ",
        "first_name": "TAMMY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP0467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342709",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.