Individual provider Active NPI

Kaitlyn Leigh Spradling

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1750827077
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP9705 Issued in AZ
Practice address
1460 W Valencia Rd
Tucson, AZ 85746-6001
Phone
(520) 573-0966
Fax
(520) 573-3930
NPI assigned
Jan 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 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 AP9705 AZ Primary

Addresses

Primary practice location

1460 W Valencia Rd
Tucson, AZ 85746-6001

Mailing address

1460 W Valencia Rd
Tucson, AZ 85746-6001
Phone (520) 573-0966

Other identifiers 1

IdentifierTypeStateIssuer
1750827077MedicaidAZ

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
I20170619002227 AZ Practitioner - Nurse Practitioner 0547538472 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP9705AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC CurrentSince May 1, 2017 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince May 1, 2017 Accepting new patients
Arizona Medical Services, PC PastSince Apr 28, 2005 Accepting new patients

Locations

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

1460 W Valencia Rd
Tucson, AZ 85746
Phone (520) 573-0966

1669 W Ina Rd
Ste 141
Tucson, AZ 85704
Phone (520) 795-6183

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": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1750827077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 W VALENCIA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857466001",
            "telephone_number": "520-573-0966",
            "fax_number": "520-257-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 W VALENCIA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857466001",
            "telephone_number": "520-573-0966",
            "fax_number": "520-573-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRADLING",
        "first_name": "KAITLYN",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750827077",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.