Active NPI
Ty M Tallman, N.M.D.
- Naturopath
- Mesa, AZ
National Provider Identifier
1770614307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 04-792
- Practice address
- 1910 S Stapley Dr Ste 120
Mesa, AZ 85204-6676 - Phone
- (480) 219-2624
- Fax
- (888) 210-1237
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Integrative Medicine Physician | 202D00000X | 04-792 | AZ | |
| Integrative Medicine Physician | 202D00000X | 4461 | OR | |
| Obesity Medicine (Preventive Medicine) Physician | 2083B0002X | 04-792 | AZ | |
| General Practice Physician | 208D00000X | 04-792 | AZ | |
| Naturopath | 175F00000X | 04-792 | AZ | Primary |
Addresses
Primary practice location
1910 S Stapley Dr Ste 120
Mesa, AZ 85204-6676
Mailing address
11445 E Via Linda
Ste 2 #604
Scottsdale, AZ 85259-2655
Phone (480) 219-2624
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4461 | OR | MD | Integrative Medicine Physician |
| 04-792 | AZ | MD | Obesity Medicine (Preventive Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752451200000",
"number": "1770614307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11445 E VIA LINDA",
"address_2": "STE 2 #604",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852592655",
"telephone_number": "480-219-2624",
"fax_number": "480-629-5651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 S STAPLEY DR STE 120",
"city": "MESA",
"state": "AZ",
"postal_code": "852046676",
"telephone_number": "480-219-2624",
"fax_number": "888-210-1237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLMAN",
"first_name": "TY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "N.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2025-07-14",
"certification_date": "2025-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "202D00000X",
"taxonomy_group": "",
"desc": "Integrative Medicine",
"state": "AZ",
"license": "04-792",
"primary": false
},
{
"code": "202D00000X",
"taxonomy_group": "",
"desc": "Integrative Medicine",
"state": "OR",
"license": "4461",
"primary": false
},
{
"code": "2083B0002X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Obesity Medicine",
"state": "AZ",
"license": "04-792",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "AZ",
"license": "04-792",
"primary": false
},
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "AZ",
"license": "04-792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.