NPIMap

Individual provider Active NPI

Joanne Rosalyn Tollerton, MD

  • Family Medicine Physician
  • Chinle, AZ
National Provider Identifier
1639174915
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55167 Issued in AZ
Practice address
U.S. 191 & Hospital Drive
Chinle, AZ 86503-8000
Phone
(928) 674-7001
Fax
(928) 674-7008
NPI assigned
Jun 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 78395 CA
Family Medicine Physician 207Q00000X MD19261 OR
Family Medicine Physician 207Q00000X 55167 AZ Primary

Addresses

Primary practice location

U.S. 191 & Hospital Drive
Chinle, AZ 86503-8000

Mailing address

PO Box PH
Chinle, AZ 86503-8000
Phone (928) 674-7001

Other identifiers 1

IdentifierTypeStateIssuer
072368MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100504000671 TX Practitioner - Family Practice 2264560796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.86 of 100Reported as group
Quality
61.32
Improvement activities
40
Cost
90.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55167AZMDFamily Medicine Physician
MD19261ORMDFamily Medicine Physician
78395CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Apr 2, 2024 Accepting new patients
County of Clackamas Office of County Auditor Past Accepting new patients

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1639174915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX PH",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "865038000",
            "telephone_number": "928-674-7001",
            "fax_number": "928-674-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "U.S. 191 & HOSPITAL DRIVE",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "865038000",
            "telephone_number": "928-674-7001",
            "fax_number": "928-674-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLERTON",
        "first_name": "JOANNE",
        "middle_name": "ROSALYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "78395",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD19261",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "55167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072368",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chinle, AZ

Sources for this page

Verify at the official NPI Registry.