Individual provider Active NPI

Cheryl W Ross, NP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1215048210
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP2494 Issued in AZ
Practice address
6261 N la Cholla Blvd Ste 277
Tucson, AZ 85741-3564
Phone
(520) 877-3800
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN059578 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP2494 AZ
Women's Health Nurse Practitioner 363LW0102X AP6684 AZ
Family Nurse Practitioner 363LF0000X AP2494 AZ Primary

Addresses

Primary practice location

6261 N la Cholla Blvd Ste 277
Tucson, AZ 85741-3564

Mailing address

6261 N la Cholla Blvd Ste 277
Tucson, AZ 85741-3564
Phone (520) 877-3800

Other identifiers 1

IdentifierTypeStateIssuer
402363MedicaidAZ

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
I20040127000211 AZ Practitioner - Nurse Practitioner 0143122374 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP2494AZMDPsychiatric/Mental Health Nurse Practitioner
AP6684AZMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Aug 27, 2024 Accepting new patients
Lifeline at Alphaomega PastSince Nov 1, 2023 Accepting new patients
Lifeline Professional Counseling Services, Inc Past Accepting new patients
Lifeline Professional Counseling Services, Inc Past Accepting new patients
Marana Health Center, Inc Past Accepting new patients
Lifeline Professional Counseling Services, Inc Past Accepting new patients
Greater Phoenix Collaborative Care PC Past Accepting new patients
Arizona Medical Services, PC PastSince Apr 28, 2005 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 8

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1215048210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6261 N LA CHOLLA BLVD STE 277",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413564",
            "telephone_number": "520-877-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6261 N LA CHOLLA BLVD STE 277",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413564",
            "telephone_number": "520-877-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CHERYL",
        "middle_name": "W",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN059578",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP2494",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP6684",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP2494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402363",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.