Individual provider Active NPI

Courtney Andersen, DO

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1659019131
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R3735 Issued in AZ
Practice address
1501 N Campbell Ave
Tucson, AZ 85724-0001
Phone
(520) 626-7399
Fax
(520) 626-5652
NPI assigned
May 24, 2022
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R3735 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-0001

Mailing address

1501 N Campbell Ave
Tucson, AZ 85724-5073
Phone (520) 626-7399

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724000922 AZ Practitioner - Pediatric Medicine 8224544390 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3735AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Banner-University Medical Group CurrentSince Jul 1, 2025 Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

1501 N Campbell Ave
Tucson, AZ 85724
Phone (520) 626-7747

1625 N Campbell Ave
Tucson, AZ 85719

2167 W Orange Grove Rd
Tucson, AZ 85741
Phone (520) 544-7650

265 W Ina Rd
Tucson, AZ 85704
Phone (520) 694-8000

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2945 W Ina Rd
Ste 121
Tucson, AZ 85741
Phone (520) 694-7601

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1659019131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857245073",
            "telephone_number": "520-626-7399",
            "fax_number": "520-626-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857240001",
            "telephone_number": "520-626-7399",
            "fax_number": "520-626-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "R3735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.