Individual provider Active NPI

McKenna Neville, DNP, FNP-C

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1639721293
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
257364 Issued in AZ
Practice address
9348 E Rita Rd Ste 180
Tucson, AZ 85747-6303
Phone
(520) 324-1036
Fax
(520) 324-1035
NPI assigned
Jul 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 94188383102 UT
Family Nurse Practitioner 363LF0000X 9418838-4405 UT
Family Nurse Practitioner 363LF0000X 9418838-8900 UT
Family Nurse Practitioner 363LF0000X 257364 AZ Primary

Addresses

Primary practice location

9348 E Rita Rd Ste 180
Tucson, AZ 85747-6303

Mailing address

1329 W 300 S
Farmington, UT 84025-5503

Other practice location 1

10350 E Drexel Rd Unit 110
Tucson, AZ 85747-9409
Phone (520) 324-1727

Other practice location 2

70 N Harrison Rd
Tucson, AZ 85748-3260
Phone (520) 324-4403

Other identifiers 1

IdentifierTypeStateIssuer
094543MedicaidAZ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210518002849 AZ Practitioner - Nurse Practitioner 2365841681 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

9348 E Rita Rd
Suite 180
Tucson, AZ 85747-6312
Phone (520) 324-4499

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
94188383102UTMDPediatric Registered Nurse
257364AZMDFamily Nurse Practitioner
9418838-4405UTMDFamily Nurse Practitioner
9418838-8900UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Jul 1, 2021 Accepting new patients
TMC Urgent Care CurrentSince Aug 4, 2024 Accepting new patients
TMC Urgent Care CurrentSince Sep 1, 2021 Accepting new patients
Saguaro Physicians, LLC Family PastSince Oct 1, 2007 Accepting new patients

Locations

9348 E Rita Rd
Ste 180
Tucson, AZ 85747
Phone (520) 324-4499

2424 N Wyatt Dr
Ste 140
Tucson, AZ 85712
Phone (520) 324-4690

10350 E Drexel Rd
Unit 110
Tucson, AZ 85747
Phone (520) 324-1727

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

9348 E Rita Rd
Ste 140
Tucson, AZ 85747
Phone (520) 324-1036

70 N Harrison Rd
Tucson, AZ 85748
Phone (520) 324-4403

10350 E Drexel Rd
Unit 170
Tucson, AZ 85747
Phone (520) 324-8070

9348 E Rita Rd
Ste 100
Tucson, AZ 85747
Phone (520) 324-4760

9356 E Rita Rd
Ste 100
Tucson, AZ 85747
Phone (520) 322-8361

9356 E Rita Rd
Ste 180
Tucson, AZ 85747
Phone (520) 324-4499

Organizations & group practices 4

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 1

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": "1563062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1639721293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 W 300 S",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840255503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9348 E RITA RD STE 180",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857476303",
            "telephone_number": "520-324-1036",
            "fax_number": "520-324-1035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10350 E Drexel Rd Unit 110",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857479409",
            "country_code": "US",
            "telephone_number": "520-324-1727",
            "fax_number": "520-324-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 N Harrison Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857483260",
            "country_code": "US",
            "telephone_number": "520-324-4403",
            "fax_number": "520-324-1409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "MCKENNA",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-14",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "UT",
            "license": "94188383102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9418838-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9418838-8900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "257364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094543",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.