Tina Renee Mickle, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

TAP10322 Issued in AZ

Practice address

7700 E Florentine Rd Ste 101
Prescott Valley, AZ 86314-2245

Phone

(928) 442-8710

Fax

(928) 442-8742

NPI assigned

Jul 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yavapai Regional Medical Center Physician Care LLCGroup PAC ID 5294898987, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels Care Home Health of Arizona Home health agency, Cottonwood, AZ, CCN 037217
• Nurses Network by Quality Home Health Care Home health agency, Prescott Valley, AZ, CCN 037154
• Mountain Valley Home for Health Home health agency, Prescott Valley, AZ, CCN 037456
• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Yavapai Regional Medical Center Physician Care LLC

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1255582003
  Medicare reassignment Care Compare group NPD
• Prescott Healthcare Solutions LLC

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1821454505
  Medicare reassignment NPD
• Yavapai Regional Medical Center Physician Care LLC

  • Internal Medicine Physician
  • Prescott, AZ
  • NPI 1083940399
  NPD
• Yavapai Regional Medical Center Physician Care LLC

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1528394830
  NPD
• Moblie Health Care Solutions, LLC

  • Pharmacy
  • Prescott Valley, AZ
  • NPI 1396170106
  NPD (past)
• Prescott Gastroenterology

  • Gastroenterology Physician
  • Prescott, AZ
  • NPI 1720110984
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Angels Touch, Inc

  • Home Health Agency
  • Cottonwood, AZ
  • NPI 1821083882
  Care Compare affiliation
• Mountain Valley Regional Rehabilitation Hospital Inc

  • Home Health Agency
  • Prescott Valley, AZ
  • NPI 1174904130
  Care Compare affiliation
• Nurses Network Incorporated

  • Home Health Agency
  • Prescott Valley, AZ
  • NPI 1215990486
  Care Compare affiliation
• Yavapai Community Hospital Association

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1215450374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 E FLORENTINE RD STE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142245",
            "telephone_number": "928-442-8710",
            "fax_number": "928-442-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLE",
        "first_name": "TINA",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP10322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Allison Messerly, RN
• Metro Care Services, Inc
• Shelly Meyers, RN
• Michael J Bryan MD PLLC
• Nada Mickelson, NP
• Aimee Susanne Midkiff, CCG
• Preston David Miller, PA-C
• Steven Chase Miller, LMT
• Ashley Kristen Millikan, PTA
• Mingus Mountain Estate Residencial Center, Inc.

• Family Nurse Practitioner in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.