Individual provider Active NPI

Tonya Scott, NP

  • Gerontology Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1801327507
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704205624 Issued in MI
Practice address
21415 Civic Center Dr
#355
Southfield, MI 48076-3909
Phone
(248) 353-6200
Fax
(248) 353-7366
NPI assigned
Mar 23, 2017
Last updated
May 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704205624 MI Primary

Addresses

Primary practice location

21415 Civic Center Dr
#355
Southfield, MI 48076-3909

Mailing address

20415 Civic Center Dr
Suit# 355
Southfield, MI 48076
Phone (248) 353-6200

Other names 1

  • Tonya Stanley Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH, IA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180228001248 MI Practitioner - Nurse Practitioner 2163799792 Reassigns benefits to 1 organization
I20230216002773 OH Practitioner - Nurse Practitioner 2163799792 Reassigns benefits to 1 organization
I20260228000660 IA Practitioner - Nurse Practitioner 2163799792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Dec 1, 2022 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Dec 1, 2022 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 28, 2024 Accepting new patients
Robyn L. Dragoo, OD PC PastSince Feb 13, 2018 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Integrated Physician Solutions PC PastSince Oct 13, 2018 Accepting new patients

Locations

2920 Telegraph Ave
Ste 100
Berkeley, CA 94705
Phone (415) 329-3727

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 355-4719

4173 Worth Ave
#K105
Columbus, OH 43219
Phone (740) 268-2656

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1801327507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20415 CIVIC CENTER DR",
            "address_2": "SUIT# 355",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48076",
            "telephone_number": "248-353-6200",
            "fax_number": "248-353-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21415 CIVIC CENTER DR",
            "address_2": "#355",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763909",
            "telephone_number": "248-353-6200",
            "fax_number": "248-353-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "TONYA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704205624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONYA",
            "last_name": "STANLEY",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.