Individual provider Active NPI

Shu-Fen Wung, PHD, ACNP

  • Acute Care Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1215910658
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN115766 Issued in AZ
Practice address
2122 N Craycroft Rd
Ste 102
Tucson, AZ 85712-2849
Phone
(520) 722-2400
Fax
(520) 323-7532
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN115766 AZ Primary

Addresses

Primary practice location

2122 N Craycroft Rd
Ste 102
Tucson, AZ 85712-2849

Mailing address

2122 N Craycroft Rd
Ste 102
Tucson, AZ 85712-2849
Phone (520) 722-2400

Other identifiers 2

IdentifierTypeStateIssuer
892267MedicaidAZ
RN115786OtherAZRN LICENSE

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
I20040423001157 AZ Practitioner - Nurse Practitioner 8022004027 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
RN115766AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unicareteam PLLC Current Accepting new patients
Pinnacle Healthcare, LLC CurrentSince Feb 5, 2014 Accepting new patients
Arizona Acute Medical Services 1 PC CurrentSince Apr 1, 2017 Accepting new patients
Pima Heart Physicians, PC Past Accepting new patients
Arizona Post-Acute Medical Services 1 PC Past Accepting new patients
Pima Heart Physicians, PC Past Accepting new patients
Pima Heart Physicians, PC Past Accepting new patients

Locations

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

5301 E Grant Rd
Unit 600
Tucson, AZ 85712

6890 E Sunrise Dr
Ste 120
Tucson, AZ 85750
Phone (520) 408-4321

2001 N Park Ave
Tucson, AZ 85719
Phone (520) 882-3558

5830 E Pima St
Tucson, AZ 85712
Phone (520) 722-5515

1921 W Hospital Dr
Tucson, AZ 85704
Phone (520) 544-5200

5663 E Grant Rd
Tucson, AZ 85712
Phone (520) 336-9179

1785 E Skyline Dr
Ste 181
Tucson, AZ 85718
Phone (520) 433-4964

Organizations & group practices 7

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1215910658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 N CRAYCROFT RD",
            "address_2": "STE 102",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122849",
            "telephone_number": "520-722-2400",
            "fax_number": "520-323-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 N CRAYCROFT RD",
            "address_2": "STE 102",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122849",
            "telephone_number": "520-722-2400",
            "fax_number": "520-323-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNG",
        "first_name": "SHU-FEN",
        "credential": "PHD, ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "RN115766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "892267",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN115786",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.