Victoria O Soyannwo

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

42824 Issued in AZ

Practice address

1601 E Apache Park PL
Tucson, AZ 85714-1775

Phone

(520) 746-0260

Fax

(520) 295-0834

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Victoria O Raiwe Former name

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

Specialty

Psychiatry

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sonora Behavioral Health Hospital LLCGroup PAC ID 6406857440, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sonora Behavioral Health Hospital, LLC

  • Psychiatric Hospital
  • Tucson, AZ
  • NPI 1750466892
  Medicare reassignment Care Compare group NPD
• Sonora Behavioral Health Hospital, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1245777481
  NPD
• La Frontera Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1932404225
  NPD (past)
• Lafrontera Center Inc

  • Methadone Clinic
  • Tucson, AZ
  • NPI 1548361470
  NPD (past)
• Lafrontera Center Inc.

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1073614905
  NPD (past)
• Marana Health Center, Inc

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527292800000",
    "number": "1720141815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 N CORONA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041096",
            "telephone_number": "520-682-4111",
            "fax_number": "520-682-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E APACHE PARK PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857141775",
            "telephone_number": "520-746-0260",
            "fax_number": "520-295-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOYANNWO",
        "first_name": "VICTORIA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2018-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "42824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03728354",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "RAIWE",
            "middle_name": "O",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Earl Taylor Spader, D.M.D.
• Brianne Mae Spaeth

• Psychiatry Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.