Individual provider Active NPI

Laura Sandra Willingmyre, MD

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1699856534
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
43889 Issued in AZ
Practice address
2355 N Wyatt Dr Ste 101
Tucson, AZ 85712-2120
Phone
(520) 616-4948
Fax
(520) 616-4958
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43889 AZ Primary

Addresses

Primary practice location

2355 N Wyatt Dr Ste 101
Tucson, AZ 85712-2120

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111

Other identifiers 1

IdentifierTypeStateIssuer
1209701MedicaidNJ

Other names 1

  • Sandra Willingmyre Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://renewedmedicalhealth.com

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
I20201026001099 AZ Practitioner - Internal Medicine 0042290926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marana Health Center IncGroup PAC ID 2365348091, 114 clinicians

Practice addresses (Care Compare)

3690 S Park Ave
Tucson, AZ 85713-5042
Phone (520) 616-6760

899 N Wilmot Rd
Tucson, AZ 85711-1712
Phone (520) 290-1100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43889AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marana Health Center, Inc Internal Medicine CurrentSince Jan 1, 2025 Accepting new patients
Renewed Medical Health CurrentSince Oct 16, 2020 Accepting new patients
Marana Health Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Marana Health Center, Inc Past Accepting new patients
Marana Health Center, Inc Past Accepting new patients

Locations

2825 E Broadway Blvd
Tucson, AZ 85716
Phone (520) 298-0005

2355 N Wyatt Dr
Ste 101
Tucson, AZ 85712
Phone (520) 616-4948

3690 S Park Ave
Ste 805
Tucson, AZ 85713
Phone (520) 616-1560

899 N Wilmot Rd
Ste B
Tucson, AZ 85711
Phone (520) 290-1100

Interoperability endpoints

  • Direct secure messaging: laura.willingmyre.1@32652.direct.athenahealth.com

Organizations & group practices 5

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1699856534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 N WYATT DR STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122120",
            "telephone_number": "520-616-4948",
            "fax_number": "520-616-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLINGMYRE",
        "first_name": "LAURA",
        "middle_name": "SANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "43889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1209701",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://renewedmedicalhealth.com",
            "affiliation": "N",
            "address_1": "2825 E Broadway Blvd",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857165309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "WILLINGMYRE",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.