Individual provider Active NPI

Laurie Anne McMahon, FNP-C

  • Family Medicine Physician
  • Vail, AZ
National Provider Identifier
1992343362
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
235884 Issued in AZ
Practice address
13105 E Colossal Cave Rd Unit 3
Vail, AZ 85641-6775
Phone
(520) 686-2079
Fax
(520) 337-6340
NPI assigned
Dec 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 235884 AZ Primary

Addresses

Primary practice location

13105 E Colossal Cave Rd Unit 3
Vail, AZ 85641-6775

Mailing address

13105 E Colossal Cave Rd Unit 3
Vail, AZ 85641-6775
Phone (520) 686-2079

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
I20200304002288 AZ Practitioner - Nurse Practitioner 9436586336 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Benson Hospital Corporation CurrentSince Sep 1, 2022 Accepting new patients
Benson Hospital Corporation CurrentSince Sep 1, 2022 Accepting new patients
Sunset Weight and Wellness LLC Current Accepting new patients
Marana Health Center, Inc Past Accepting new patients
TMC Medical Network PastSince Dec 1, 2023 Accepting new patients

Locations

450 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-2261

890 W 4th St
Benson, AZ 85602
Phone (520) 586-3664

13370 E Mary Ann Cleveland Way
Ste 102
Vail, AZ 85641
Phone (520) 585-5002

13370 E Mary Ann Cleveland Way
Vail, AZ 85641
Phone (520) 689-7144

Organizations & group practices 5

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": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1992343362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 E COLOSSAL CAVE RD UNIT 3",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856416775",
            "telephone_number": "520-686-2079",
            "fax_number": "520-337-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13105 E COLOSSAL CAVE RD UNIT 3",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856416775",
            "telephone_number": "520-686-2079",
            "fax_number": "520-337-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "LAURIE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "235884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vail, AZ

Sources for this page

Verify at the official NPI Registry.