Individual provider Active NPI

Mary C. Marcantel, N.D.

  • Naturopath
  • Gold Canyon, AZ
National Provider Identifier
1396896031
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
04-791 Issued in AZ
Practice address
6589 S Kings Ranch Rd Ste 102B
Gold Canyon, AZ 85118-2933
Phone
(480) 738-1647
Fax
(480) 779-6317
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 04-791 AZ Primary

Addresses

Primary practice location

6589 S Kings Ranch Rd Ste 102B
Gold Canyon, AZ 85118-2933

Mailing address

4718 S Jalapa LN
Gold Canyon, AZ 85118-1824
Phone (480) 980-8022

Other names 1

  • Dr. Tina Marcantel Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
04-791AZMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1396896031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4718 S JALAPA LN",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851181824",
            "telephone_number": "480-980-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6589 S KINGS RANCH RD STE 102B",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851182933",
            "telephone_number": "480-738-1647",
            "fax_number": "480-779-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCANTEL",
        "first_name": "MARY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "N.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "04-791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "MARCANTEL",
            "prefix": "DR.",
            "credential": "N.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gold Canyon, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.