Individual provider Active NPI

Tina M Horton, PA-C

  • Physician Assistant
  • Chandler, AZ
National Provider Identifier
1467456418
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2767 Issued in AZ
Practice address
2121 W Chandler Blvd
Suite 110
Chandler, AZ 85224-6545
Phone
(480) 963-2233
Fax
(480) 963-2277
NPI assigned
Jun 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2767 AZ Primary

Addresses

Primary practice location

2121 W Chandler Blvd
Suite 110
Chandler, AZ 85224-6545

Mailing address

2121 W Chandler Blvd
Suite 110
Chandler, AZ 85224
Phone (480) 963-2233

Other identifiers 2

IdentifierTypeStateIssuer
AZ0146780OtherAZBCBS
880858MedicaidAZ

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027000159 AZ Practitioner - Physician Assistant 0547454266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: tina.horton.1@25559.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1467456418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 W CHANDLER BLVD",
            "address_2": "SUITE 110",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85224",
            "telephone_number": "480-963-2233",
            "fax_number": "480-963-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W CHANDLER BLVD",
            "address_2": "SUITE 110",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246545",
            "telephone_number": "480-963-2233",
            "fax_number": "480-963-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "TINA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0146780",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880858",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.