Individual provider Active NPI

Tora J Gerrick, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • San Tan Valley, AZ
National Provider Identifier
1376750992
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
226417 Issued in AZ
Practice address
36375 N Gantzel Rd
San Tan Valley, AZ 85140-7333
Phone
(602) 689-8772
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 226417 AZ Primary

Addresses

Primary practice location

36375 N Gantzel Rd
San Tan Valley, AZ 85140-7333

Mailing address

36375 N Gantzel Rd
San Tan Valley, AZ 85140-7333

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613001802 AZ Practitioner - Certified Nurse Midwife (CNM) 9436516085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hera Health Medical Group - Az PLLCGroup PAC ID 8729458864, 6 clinicians

Practice addresses (Care Compare)

2222 E Highland Ave
Suite 210
Phoenix, AZ 85016-4876
Phone (480) 866-8787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Hera Health Medical Group - Az PLLC CurrentSince Jun 15, 2023 Accepting new patients
Birthways Midwifery, LLC Past Accepting new patients
Banner Ironwood Medical Center Past Accepting new patients

Locations

2222 E Highland Ave
Ste 210
Phoenix, AZ 85016
Phone (480) 661-1332

36375 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (602) 689-8772

36375 N Gantzel Rd
Ste 103
San Tan Vly, AZ 85140
Phone (480) 987-5500

Interoperability endpoints

  • Direct secure messaging: tora.gerrick.1@27149.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1376750992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36375 N GANTZEL RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36375 N GANTZEL RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407333",
            "telephone_number": "602-689-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERRICK",
        "first_name": "TORA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "AZ",
            "license": "226417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

Verify at the official NPI Registry.