Active NPI
Tonya M Roach, CRNP
- Family Nurse Practitioner
- Mobile, AL
National Provider Identifier
1376978262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-106985
- Practice address
- 251 N Bayou St
Mobile, AL 36603-5827 - Phone
- (251) 690-8158
- Fax
- (251) 544-2188
- NPI assigned
- Sep 10, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-106985 | AL | Primary |
Addresses
Primary practice location
251 N Bayou St
Mobile, AL 36603-5827
Mailing address
251 N Bayou St
Mobile, AL 36603-5827
Phone (251) 690-8158
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063439065 | Other | AL | NPI GROUP PAYEE NUMBER |
| 630000013 | Medicaid | AL | |
| 011846 | Other | AL | MEDICARE GROUP PAYEE NUMBER |
Other names 1
- Tonay M Tucker
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-106985 | AL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile County Board of Health | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Mobile, AL
- NPI 1659584555
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378771200000",
"number": "1376978262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 N BAYOU ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366035827",
"telephone_number": "251-690-8158",
"fax_number": "251-544-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 N BAYOU ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366035827",
"telephone_number": "251-690-8158",
"fax_number": "251-544-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROACH",
"first_name": "TONYA",
"middle_name": "M",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-10",
"last_updated": "2013-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-106985",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI GROUP PAYEE NUMBER",
"identifier": "1063439065",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630000013",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PAYEE NUMBER",
"identifier": "011846",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TONAY",
"last_name": "TUCKER",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.