Kathryn M Tynan, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN081159 Issued in AZ

Practice address

5757 Plaza Dr
Cypress, CA 90630-5000

Phone

(763) 361-7002

NPI assigned

Nov 2, 2005

Last updated

Jun 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10556/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/27327/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TLC Healthcare Medical Group PC

  dba Scott M Bolhack MD PC

  • Geriatric Medicine (Family Medicine) Physician
  • Tucson, AZ
  • NPI 1720157464
  Medicare reassignment NPD
• TLC Healthcare Wound Specialists Inc

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1699918235

  Adult Health

  NPD
• Agape Hospice & Palliative Care, LLC

  • Community Based Hospice Care Agency
  • Tucson, AZ
  • NPI 1679826549
  NPD (past)
• Providers Direct, PLLC

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1073795852
  NPD (past)
• Rehab Solutions, LLC

  dba Triad Medical Group

  • Geriatric Medicine (Internal Medicine) Physician
  • Tucson, AZ
  • NPI 1679593131
  NPD (past)
• University of Arizona

  • Audiologist
  • Tucson, AZ
  • NPI 1053509679
  NPD (past)
• University of Arizona Nursing and Health Associates

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1801345004
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1508857095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3672 N WHITE PEARL LN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857499707",
            "telephone_number": "520-245-3326",
            "fax_number": "520-751-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 PLAZA DR",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305000",
            "telephone_number": "763-361-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 E Skyline Dr",
            "address_2": "SUITE 101",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857189101",
            "country_code": "US",
            "telephone_number": "520-299-3968",
            "fax_number": "520-577-3968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYNAN",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN081159",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "200550137NP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "200550138NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440777",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Lloyd Tucker, A.T.,C.
• Tiffany Ann Turner
• Tustin Urgent Care, Apc (Xpress Urgent Care Cypress)
• Jessica Marilyn Tuttle
• Mary Ann Jinky Twaddell, DMD
• Jong Um, DDS
• Ki M Um, DDS
• United Physicians International, Inc.
• University Foot and Ankle Institute a Podiatric Surgical Center
• Chinenye Utom

• Adult Health Nurse Practitioner in Cypress, CA
• Providers in Cypress, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.