Active NPI
Placita Mobile Primary, LLC
- Nurse Practitioner
- Tucson, AZ
National Provider Identifier
1821808650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- PLACITA MOBILE PRIMARY, LLC
- Practice address
- 6303 E Tanque Verde Rd Ste 311
Tucson, AZ 85715-3857 - Phone
- (520) 904-4274
- NPI assigned
- Jan 13, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Keith Condon
- Title
- Managing Member
- Phone
- (520) 904-4274
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
6303 E Tanque Verde Rd Ste 311
Tucson, AZ 85715-3857
Mailing address
333 N Wilmot Rd Ste 340
Tucson, AZ 85711-2607
Phone (520) 904-4274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250911002816 | AZ | Part B Supplier - Clinic/Group Practice | 2264935618 |
Receives reassigned benefits from 9 practitioners Practice locations: Sun City, AZ; Tucson, AZ |
National Provider Directory
National Provider DirectoryLocations
6303 E Tanque Verde Rd
Ste 311
Tucson, AZ 85715
Phone (520) 308-7889
8701 S Kolb Rd
#9204
Tucson, AZ 85756
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- Tucson, AZ
- NPI 1821777608
AZ, Nurse Practitioner
-
- Internal Medicine Physician
- Tucson, AZ
- NPI 1184335085
AZ, Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736726400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736899200000",
"number": "1821808650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N WILMOT RD STE 340",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857112607",
"telephone_number": "520-904-4274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6303 E TANQUE VERDE RD STE 311",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857153857",
"telephone_number": "520-904-4274"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLACITA MOBILE PRIMARY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-13",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A",
"authorized_official_last_name": "CONDON",
"authorized_official_first_name": "KEITH",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "520-904-4274"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.