Organization Active NPI

Tucson Family Care, LLC

  • Primary Care Clinic/Center
  • Tucson, AZ
National Provider Identifier
1265786388
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TUCSON FAMILY CARE, LLC
Practice address
6624 E Carondelet Dr
Tucson, AZ 85710-2119
Phone
(520) 818-8477
Fax
(520) 333-3132
NPI assigned
Oct 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Authorized official

Name
Dr. Brenda Ann Wells, M.D.NPI 1356372023
Title
Physician/Owner
Phone
(520) 818-8477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

6624 E Carondelet Dr
Tucson, AZ 85710-2119

Mailing address

6624 E. Carondelet
Tucson, AZ 85712-5638
Phone (520) 818-8477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130212000463 AZ Part B Supplier - Clinic/Group Practice 5395999775 Receives reassigned benefits from 9 practitioners
Practice locations: Tucson, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2049021Tucson Family Care6624 E Carondelet Dr, Tucson, AZ 85710Certificate of waiverOct 28, 2026

National Provider Directory

National Provider Directory

Locations

6624 E Carondelet Dr
Tucson, AZ 85710
Phone (520) 818-8477

310 N Wilmot Rd
Ste 104
Tucson, AZ 85711
Phone (520) 318-1996

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503532800000",
    "number": "1265786388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6624 E. CARONDELET",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857125638",
            "telephone_number": "520-818-8477",
            "fax_number": "520-333-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 E CARONDELET DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102119",
            "telephone_number": "520-818-8477",
            "fax_number": "520-333-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUCSON FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2017-08-24",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "520-818-8477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.