Lupita Ann Weatherwax, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

248936 Issued in AZ

Practice address

3100 N Glassford Hill Rd
Prescott Valley, AZ 86314-2285

Phone

(928) 777-7820

Fax

(928) 777-7821

NPI assigned

Feb 19, 2018

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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lupita.weatherwax@krogerhealth.eclinicaldirectplus.com

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.

• Mobileonedocs, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Scottsdale, AZ
  • NPI 1629424379
  Medicare reassignment NPD
• The Little Clinic of Arizona LLC

  • Family Nurse Practitioner
  • Buckeye, AZ
  • NPI 1023216249
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ

  Medicare reassignment NPD
• Mobileonedocs, LLC

  • Family Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1740858950
  NPD

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1720588486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 N KINGS HWY W",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142808",
            "telephone_number": "928-261-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 N GLASSFORD HILL RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142285",
            "telephone_number": "928-777-7820",
            "fax_number": "928-777-7821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4845 S Sheridan Rd Ste 509",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741455719",
            "country_code": "US",
            "telephone_number": "918-660-0031",
            "fax_number": "918-660-0056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3100 N Glassford Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142285",
            "country_code": "US",
            "telephone_number": "928-777-7820",
            "fax_number": "928-777-7821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEATHERWAX",
        "first_name": "LUPITA",
        "middle_name": "ANN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "248936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083250",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Jean Ward, FNP-C
• Roy Ware, R.PH.
• Ryan Jacob Warinner, SPTA
• Robert Warman, D.C
• Laura Ann Warta
• Carol A Weitkunat, P.T.
• Shannon Welch, APRN
• Brooke Werner, OTR/L
• West Yavapai Guidance Clinic Inc
• West Yavapai Guidance Clinic Inc

• Family Nurse Practitioner in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.

Verify at the official NPI Registry.