Individual provider Active NPI

Mark Siemon, PHD, RN, PHNA-BC

  • Community Health Registered Nurse
  • Teec Nos Pos, AZ
National Provider Identifier
1639016264
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
338113 Issued in AZ
Practice address
Hwy 160 & Navajo Route 35
Teec Nos Pos, AZ 86514-9604
Phone
(928) 656-5308
NPI assigned
May 1, 2026
Last updated
May 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 338113 AZ Primary

Addresses

Primary practice location

Hwy 160 & Navajo Route 35
Teec Nos Pos, AZ 86514-9604

Mailing address

HC 61 Box 3054
Teec Nos Pos, AZ 86514-9604
Phone (928) 656-5308

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
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
338113AZMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1777593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1639016264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 61 BOX 3054",
            "city": "TEEC NOS POS",
            "state": "AZ",
            "postal_code": "865149604",
            "telephone_number": "928-656-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 160 & NAVAJO ROUTE 35",
            "city": "TEEC NOS POS",
            "state": "AZ",
            "postal_code": "865149604",
            "telephone_number": "928-656-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMON",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PHD, RN, PHNA-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-01",
        "last_updated": "2026-05-01",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "AZ",
            "license": "338113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teec Nos Pos, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.