Active NPI
Tina Fawcett, AGACNP
- Nurse Practitioner
- Flagstaff, AZ
National Provider Identifier
1326422700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP8563
- Practice address
- 1360 N Rim Dr
Flagstaff, AZ 86001-3111 - Phone
- (928) 774-8000
- Fax
- (928) 774-0372
- NPI assigned
- Jul 15, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 354619-4405 | UT | |
| Nurse Practitioner | 363L00000X | AP8563 | AZ | Primary |
Addresses
Primary practice location
1360 N Rim Dr
Flagstaff, AZ 86001-3111
Mailing address
1360 N Rim Dr
Flagstaff, AZ 86001-3111
Phone (928) 773-0003
Other practice location 1
5620 W Thunderbird Rd Ste B3
Glendale, AZ 85306-4638
Phone (602) 206-6262
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP8563 | Other | AZ | ARIZONA LICENSE |
| 176578 | Medicaid | AZ |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160914002748 | AZ | Practitioner - Nurse Practitioner | 9931416013 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1360 N Rim Dr
Flagstaff, AZ 86001-3111
Phone (928) 774-8000
5620 W Thunderbird Rd
Suite B3
Glendale, AZ 85306-4638
Phone (602) 206-6262
Hospital & facility affiliations
- Summit Healthcare Regional Medical Center
- Flagstaff Medical Center
- Verde Valley Medical Center
- Yavapai Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP8563 | AZ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Patel MD PC | Current | Accepting new patients | |
| Northern Arizona Pulmonary Associates, LLC | Current | Accepting new patients | |
| Granger Medical Specialists LLC | Past | Accepting new patients |
Locations
1360 N Rim Dr
Flagstaff, AZ 86001
Phone (928) 774-3919
5620 W Thunderbird Rd
Ste B3
Glendale, AZ 85306
Phone (602) 206-6262
Organizations & group practices 3
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.
-
- Pulmonary Disease Physician
- Flagstaff, AZ
- NPI 1659516987
AZ
-
- Clinic/Center
- West Valley City, UT
- NPI 1376159368
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Health Clinic/Center
- Overgaard, AZ
- NPI 1770700767
Hospital
-
- General Acute Care Hospital
- Prescott, AZ
- NPI 1902897820
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776556800000",
"number": "1326422700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1360 N RIM DR",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013111",
"telephone_number": "928-773-0003",
"fax_number": "928-773-1170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1360 N RIM DR",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013111",
"telephone_number": "928-774-8000",
"fax_number": "928-774-0372"
}
],
"practiceLocations": [
{
"address_1": "5620 W Thunderbird Rd Ste B3",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "AZ",
"postal_code": "853064638",
"country_code": "US",
"telephone_number": "602-206-6262",
"fax_number": "602-235-0296",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAWCETT",
"first_name": "TINA",
"credential": "AGACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-15",
"last_updated": "2026-04-19",
"certification_date": "2026-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "UT",
"license": "354619-4405",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "AP8563",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA LICENSE",
"identifier": "AP8563",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "176578",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; 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.