Organization Active NPI

Full Spectrum Wellness Inc

  • General Practice Physician
  • Tucson, AZ
National Provider Identifier
1447094230
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FULL SPECTRUM WELLNESS INC
Practice address
1840 N Craycroft Rd
Tucson, AZ 85712-3702
Phone
(520) 372-8427
Fax
(520) 264-0126
NPI assigned
Jun 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Dr. Kristin Makinajyan, FNP/DNPNPI 1851197016
Title
Nurse Practitioner
Phone
(626) 215-5900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1840 N Craycroft Rd
Tucson, AZ 85712-3702

Mailing address

1840 N Craycroft Rd
Tucson, AZ 85712-3702
Phone (520) 372-8427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241023001699 AZ Part B Supplier - Clinic/Group Practice 6103359666 Receives reassigned benefits from 3 practitioners
Practice locations: Tucson, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2337418Full Spectrum Wellness1840 N Craycroft Rd, Tucson, AZ 85712Certificate of waiverJan 21, 2028

National Provider Directory

National Provider Directory

Locations

1840 N Craycroft Rd
Tucson, AZ 85712
Phone (520) 886-2822

7660 E Broadway Blvd
Ste 210
Tucson, AZ 85710
Phone (323) 333-5240

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1447094230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 N CRAYCROFT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123702",
            "telephone_number": "520-372-8427",
            "fax_number": "520-264-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 N CRAYCROFT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123702",
            "telephone_number": "520-372-8427",
            "fax_number": "520-264-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SPECTRUM WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "MAKINAJYAN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "626-215-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP/DNP"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.