Active NPI
Mark Thomas Nanney
- Family Medicine Physician
- Tucson, AZ
National Provider Identifier
1578735809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20528
- Practice address
- 2830 N Camino de Oeste
Tucson, AZ 85745-9201 - Phone
- (520) 743-1296
- NPI assigned
- Mar 26, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20528 | AZ | Primary |
Addresses
Primary practice location
2830 N Camino de Oeste
Tucson, AZ 85745-9201
Mailing address
2830 N Camino de Oeste
Tucson, AZ 85745-9201
Phone (520) 743-1296
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20528 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206489600000",
"number": "1578735809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2830 N CAMINO DE OESTE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857459201",
"telephone_number": "520-743-1296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2830 N CAMINO DE OESTE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857459201",
"telephone_number": "520-743-1296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANNEY",
"first_name": "MARK",
"middle_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-26",
"last_updated": "2008-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "20528",
"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 Mar 26, 2008; 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.