Active NPI
Tammy Renee Heredia, RN
- School Registered Nurse
- Sierra Vista, AZ
National Provider Identifier
1629741012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 257842
- Practice address
- 905 El Camino Real
Sierra Vista, AZ 85635-5456 - Phone
- (520) 515-2996
- NPI assigned
- Jul 30, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 257842 | AZ | Primary |
Addresses
Primary practice location
905 El Camino Real
Sierra Vista, AZ 85635-5456
Mailing address
905 El Camino Real
Sierra Vista, AZ 85635-5456
Phone (520) 515-2996
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163WS0200X | Medicaid | AZ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | School_District |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 257842 | AZ | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1629741012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 EL CAMINO REAL",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856355456",
"telephone_number": "520-515-2996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 EL CAMINO REAL",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856355456",
"telephone_number": "520-515-2996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEREDIA",
"first_name": "TAMMY",
"middle_name": "RENEE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-30",
"last_updated": "2021-07-30",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "AZ",
"license": "257842",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "163WS0200X",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "School_District",
"affiliation": "N",
"address_1": "905 El Camino Real",
"city": "Sierra Vista",
"state": "AZ",
"country_code": "US",
"postal_code": "856355456",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sierra Vista, AZ
- Sheila Anne Heiple, RN, BSN, MA
- Amy Marie Heise, M.A. CCC-SLP
- Helping Ourselves Pursue Enrichment, Inc.
- Governor Henry Henderson III, DNP
- Julie Lynn Henderson, R.D.
- Patricia E Herrewig, LPC
- Latoya Marie Herring, MEDICAL NAILTECH MNT
- Christen Herrington, CNM
- John N Herrod, MD
- Hidden Garden Assisted Living, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.