Tall Pines Wellness

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

TALL PINES WELLNESS

Practice address

2641 W White Mountain Blvd
Lakeside, AZ 85929-6229

Phone

(928) 300-8295

NPI assigned

Dec 29, 2025

Last updated

Dec 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Alena Thompson, NPNPI 1104206879

Title

Owner

Phone

(928) 300-8295

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alena Thompson, FNP-C

  • Family Nurse Practitioner
  • Springerville, AZ
  • NPI 1104206879
  NPD Authorized official

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1891651469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 W WHITE MOUNTAIN BLVD",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859296229",
            "telephone_number": "928-300-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 W WHITE MOUNTAIN BLVD",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859296229",
            "telephone_number": "928-300-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALL PINES WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "ALENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-300-8295",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Lakeside, AZ
• Providers in Lakeside, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.

Verify at the official NPI Registry.