Individual provider Active NPI

Tracey L Bombara, FNP

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1316285901
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN115203 Issued in AZ
Practice address
4159 E Marshall Ave
Gilbert, AZ 85297-9544
Phone
(480) 883-7527
NPI assigned
Jan 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN115203 AZ Primary

Addresses

Primary practice location

4159 E Marshall Ave
Gilbert, AZ 85297-9544

Mailing address

4159 E Marshall Ave
Gilbert, AZ 85297-9544
Phone (480) 883-7527

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1316285901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4159 E MARSHALL AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979544",
            "telephone_number": "480-883-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4159 E MARSHALL AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979544",
            "telephone_number": "480-883-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBARA",
        "first_name": "TRACEY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN115203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.