Active NPI
Anevay Dettmer- Diaz
- Contractor
- Tucson, AZ
National Provider Identifier
1174922249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 6234912
- Practice address
- 7004 S Catchfly CT
Tucson, AZ 85756-5170 - Phone
- (520) 861-8173
- NPI assigned
- Aug 14, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 6234912 | AZ | Primary |
Addresses
Primary practice location
7004 S Catchfly CT
Tucson, AZ 85756-5170
Mailing address
7004 S Catchfly CT
Tucson, AZ 85756-5170
Phone (520) 861-8173
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 |
|---|---|---|---|
| 6234912 | AZ | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1174922249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7004 S CATCHFLY CT",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857565170",
"telephone_number": "520-861-8173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7004 S CATCHFLY CT",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857565170",
"telephone_number": "520-861-8173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETTMER- DIAZ",
"first_name": "ANEVAY",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-14",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "AZ",
"license": "6234912",
"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 Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.