Individual provider Active NPI

Leslie Carolyn Michotte, FNP-C

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1699247569
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
220264 Issued in AZ
Practice address
1501 N Campbell Ave
Tucson, AZ 85724-0001
Phone
(520) 661-3070
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 220264 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-0001

Mailing address

876 W Samalayuca Dr
Tucson, AZ 85704-3220
Phone (520) 661-3070

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
I20190222002135 AZ Practitioner - Nurse Practitioner 9436498219 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220264AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Arizona Urgent Care, LLC CurrentSince Feb 5, 2019 Accepting new patients
Southern Arizona Urgent Care LLC Current Accepting new patients
Southern Arizona Urgent Care, LLC CurrentSince Feb 5, 2019 Accepting new patients

Locations

3662 W Ina Rd
Ste 150
Tucson, AZ 85741
Phone (520) 900-7020

7725 N Oracle Rd
Ste 131
Tucson, AZ 85704
Phone (520) 544-2273

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.

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1699247569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 W SAMALAYUCA DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857043220",
            "telephone_number": "520-661-3070"
        },
        {
            "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": "520-661-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHOTTE",
        "first_name": "LESLIE",
        "middle_name": "CAROLYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "220264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.