Individual provider Active NPI

Teresa Ann Colby, FNP

  • Family Nurse Practitioner
  • Elfrida, AZ
National Provider Identifier
1316399397
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TAP8750 Issued in AZ
Practice address
10566 N Highway 191
Elfrida, AZ 85610-9021
Phone
(520) 642-2222
Fax
(520) 364-4261
NPI assigned
Jul 1, 2016
Last updated
Jul 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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 TAP8750 AZ Primary

Addresses

Primary practice location

10566 N Highway 191
Elfrida, AZ 85610-9021

Mailing address

155 Calle Portal
Suite 100
Sierra Vista, AZ 85635-2900
Phone (520) 364-1429

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
I20160907001897 AZ Practitioner - Nurse Practitioner 5496041048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Cancer Care LLCGroup PAC ID 8628328796, 6 clinicians

Practice addresses (Care Compare)

198 S Coronado Dr
Suite a
Sierra Vista, AZ 85635-6357
Phone (520) 220-5020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.79 of 100Reported as group
Quality
99.62
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TAP8750AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Cancer Care LLC CurrentSince Apr 6, 2021 Accepting new patients

Locations

198 S Coronado Dr
Ste A
Sierra Vista, AZ 85635
Phone (520) 220-5020

2250 El Mercado Loop
Sierra Vista, AZ 85635
Phone (520) 220-5020

Interoperability endpoints

  • Direct secure messaging: teresa.colby@southwestcancercare.ikm.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1316399397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CALLE PORTAL",
            "address_2": "SUITE 100",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352900",
            "telephone_number": "520-364-1429",
            "fax_number": "520-364-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10566 N HIGHWAY 191",
            "city": "ELFRIDA",
            "state": "AZ",
            "postal_code": "856109021",
            "telephone_number": "520-642-2222",
            "fax_number": "520-364-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBY",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-01",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP8750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elfrida, AZ

Sources for this page

Verify at the official NPI Registry.