Active NPI
Tanya Kalani Von Detten, M.D.
- Family Medicine Physician
- Phoenix, AZ
National Provider Identifier
1366824740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD19755
- Practice address
- 2000 W Bethany Home Rd
Family Medicine Center
Phoenix, AZ 85015-2443 - Phone
- (602) 246-5525
- NPI assigned
- Jun 23, 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | R75293 | AZ | |
| Family Medicine Physician | 207Q00000X | MD19755 | HI | Primary |
Addresses
Primary practice location
2000 W Bethany Home Rd
Family Medicine Center
Phoenix, AZ 85015-2443
Mailing address
500 University Ave Apt 1429
Honolulu, HI 96826-4938
Phone (218) 326-3636
Other practice location 1
1953 E 3rd St
Williamsport, PA 17701-3901
Phone (570) 323-4072
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD19755 | HI | MD | Family Medicine Physician |
| R75293 | AZ | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- tanya.von.detten.1@19917.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1366824740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 UNIVERSITY AVE APT 1429",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968264938",
"telephone_number": "218-326-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 W BETHANY HOME RD",
"address_2": "FAMILY MEDICINE CENTER",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850152443",
"telephone_number": "602-246-5525"
}
],
"practiceLocations": [
{
"address_1": "1953 E 3rd St",
"address_purpose": "LOCATION",
"city": "Williamsport",
"state": "PA",
"postal_code": "177013901",
"country_code": "US",
"telephone_number": "570-323-4072",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VON DETTEN",
"first_name": "TANYA",
"middle_name": "KALANI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-23",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AZ",
"license": "R75293",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "HI",
"license": "MD19755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
- Kristine Lynn Vollmer, APRN
- Keturah Frances Volpe, NP
- Jenna Leigh Volstromer, AGNP
- Lana M Volz, M.D.
- Teresa Anna Von Borries Valenti, FNP-C
- Monica Von Eggers, PHD, LPC, LISAC, NCC
- Eric Von Hess, P.T.
- Kara Von Kolen, DNP, WHNP-BC
- Stephanie Gabrielle Von Pahlen-Fedoroff, PAC
- Von Rice Chiropractic and Acupuncture LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.