Individual provider Active NPI

Ann Rodgers, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1174688170
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1157 Issued in AZ
Practice address
5575 E River Rd Ste 121-222
Tucson, AZ 85750-6743
Phone
(520) 529-8387
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN111109 AZ
Family Nurse Practitioner 363LF0000X 1157 AZ Primary

Addresses

Primary practice location

5575 E River Rd Ste 121-222
Tucson, AZ 85750-6743

Mailing address

14780 W Mountain View Blvd
Ste 110
Surprise, AZ 85374-7280
Phone (623) 374-7774

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
I20040528000309 AZ Practitioner - Nurse Practitioner 8628059276

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1157AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Outreach, Inc Past Accepting new patients
Tucsonhousecalls Past Accepting new patients
Carondelet Health Network Past Accepting new patients

Organizations & group practices 3

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1174688170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD",
            "address_2": "STE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747280",
            "telephone_number": "623-374-7774",
            "fax_number": "855-420-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 E RIVER RD STE 121-222",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857506743",
            "telephone_number": "520-529-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN111109",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "1157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.