Active NPI
Tommie Foxworth
- Prosthetics Case Management
- Mesa, AZ
National Provider Identifier
1669907150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 202
- Practice address
- 1616 E Main St
Suite 102-103
Mesa, AZ 85203-9071 - Phone
- (602) 349-2579
- Fax
- (480) 832-0299
- NPI assigned
- Apr 22, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 202 | AZ | Primary |
Addresses
Primary practice location
1616 E Main St
Suite 102-103
Mesa, AZ 85203-9071
Mailing address
7440 E Main St
09
Mesa, AZ 85207-8300
Phone (602) 425-9308
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202 | AZ | MD | Prosthetics Case Management |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492819200000",
"number": "1669907150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7440 E MAIN ST",
"address_2": "09",
"city": "MESA",
"state": "AZ",
"postal_code": "852078300",
"telephone_number": "602-425-9308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 E MAIN ST",
"address_2": "SUITE 102-103",
"city": "MESA",
"state": "AZ",
"postal_code": "852039071",
"telephone_number": "602-349-2579",
"fax_number": "480-832-0299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOXWORTH",
"first_name": "TOMMIE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-22",
"last_updated": "2017-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "AZ",
"license": "202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.