Active NPI
Kimberly K Merrill-McNurlin, PA-C
- Medical Physician Assistant
- Tucson, AZ
National Provider Identifier
1710944970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2222
- Practice address
- 6320 N. la Cholla Blvd
#200
Tucson, AZ 85741-3549 - Phone
- (520) 382-8200
- Fax
- (520) 297-3505
- NPI assigned
- Apr 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2222 | AZ | Primary |
| Surgical Physician Assistant | 363AS0400X | 2222 | AZ |
Addresses
Primary practice location
6320 N. la Cholla Blvd
#200
Tucson, AZ 85741-3549
Mailing address
PO Box 31630
Tucson, AZ 85751-1630
Phone (520) 784-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 764466 | Medicaid | AZ |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2222 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Community Surgeons PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Surgery Physician
- Tucson, AZ
- NPI 1265149488
-
- Surgery Physician
- Tucson, AZ
- NPI 1689616070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1710944970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31630",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857511630",
"telephone_number": "520-784-6200",
"fax_number": "520-784-6109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6320 N. LA CHOLLA BLVD",
"address_2": "#200",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857413549",
"telephone_number": "520-382-8200",
"fax_number": "520-297-3505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL-MCNURLIN",
"first_name": "KIMBERLY",
"middle_name": "K",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-28",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "2222",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "AZ",
"license": "2222",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "764466",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.