Individual provider Active NPI

Kathleen A Oldfather, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1487728622
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN 033432 Issued in AZ
Practice address
8050 E Lakeside Pkwy
Tucson, AZ 85730-1254
Phone
(520) 792-3293
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN 033432 AZ Primary

Addresses

Primary practice location

8050 E Lakeside Pkwy
Tucson, AZ 85730-1254

Mailing address

1477 W Commerce CT
Tucson, AZ 85746-6016
Phone (207) 923-2935

Other identifiers 2

IdentifierTypeStateIssuer
621765MedicaidAZ
AP3272OtherAZLICENSE

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
I20060426000069 AZ Practitioner - Nurse Practitioner 4385654094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cope Community Services IncGroup PAC ID 9537131198, 25 clinicians

Practice addresses (Care Compare)

8050 E Lakeside Pkwy
Tucson, AZ 85730-1254
Phone 52079232931308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN 033432AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cope Community Services, Inc. CurrentSince May 26, 2016 Accepting new patients
Cope Community Services, Inc. Current Accepting new patients
Banner-University Medical Group Past Accepting new patients

Locations

5401 E 5th St
Tucson, AZ 85711
Phone (520) 879-6680

1477 W Commerce Ct
Tucson, AZ 85746
Phone 52079232931308

620 N Craycroft Rd
Tucson, AZ 85711
Phone (520) 747-6694

924 N Alvernon Way
Ste 110
Tucson, AZ 85711
Phone (520) 207-9348

5840 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 498-3900

3332 N Los Altos Ave
Tucson, AZ 85705
Phone 52079232931308

8050 E Lakeside Pkwy
Tucson, AZ 85730
Phone (520) 584-5820

2435 N Castro Ave
Tucson, AZ 85705
Phone (520) 622-8030

1501 W Commerce Ct
Tucson, AZ 85746
Phone (520) 741-3180

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1487728622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 W COMMERCE CT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857466016",
            "telephone_number": "207-923-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 E LAKESIDE PKWY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857301254",
            "telephone_number": "520-792-3293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDFATHER",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN 033432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621765",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP3272",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.