JACOB TUTTLE (NPI# 1023370053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023370053 |
| Entity Type | Individual |
| Full Name | JACOB TUTTLE |
| Credential | MD |
| Practice Address |
2000 W Bethany Home Rd # 200 Phoenix AZ 85015 |
| Mailing Address |
2000 W Bethany Home Rd # 200 Phoenix AZ 85015-2443 |
| Practice Telephone | 6022465526 |
| Practice Fax Number | 6024336686 |
| Mailing Telephone | 6022465525 |
| Mailing Fax Number | 6024336686 |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2020-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 571891 | AZ | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01072927A | IN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 11016632A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE PTAN | M400075625 | 01 |
| IN | 201110130 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619099942 | Jacob Lee Tuttle | Physical Therapist | 302 Northridge Circle, Guymon, OK 73942-5801 | 2007-04-06 |
| 1679065106 | Jacob Tuttle | Nurse Anesthetist, Certified Registered | 201 State St, Erie, PA 16550 | 2018-05-31 |
| Street Address |
2000 W BETHANY HOME RD # 200 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558591644 | Renee M Gazda | Family Medicine | 2000 W Bethany Home Rd # 200, Phoenix, AZ 85015-2443 | 2009-07-23 |
| 1053722686 | Melissa Molyneux | Family Medicine | 2000 W Bethany Home Rd # 200, Phoenix, AZ 85015-2443 | 2014-05-16 |
| 1417245267 | Merima Bucaj | Family Medicine | 2000 W Bethany Home Rd # 200, Phoenix, AZ 85015 | 2011-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339200 | Madison Le | Family Medicine | 3037 W Cat Balue Dr, Phoenix, AZ 85027-2342 | 2020-09-04 |
| 1720604069 | Good Health Medical, PC | Family Medicine | 2632 S 83rd Ave Ste 113, Phoenix, AZ 85043-7206 | 2020-06-23 |
| 1427670751 | Florence Wellness Pllc | Family Medicine | 101 E Washington St Fl 7, Phoenix, AZ 85004-2450 | 2020-05-08 |
| 1437782257 | Jillian Knapp | Family Medicine | 521 W Butler Dr, Phoenix, AZ 85021-4526 | 2020-02-20 |
| 1861033912 | Vanessa Lissette Lara | Family Medicine | 1459 E Flower St, Phoenix, AZ 85014-5666 | 2019-09-30 |
| 1366007411 | Marceline E Ndum | Family Medicine | 10631 S. 51st Street, Suite 1, Phoenix, AZ 85044-5225 | 2019-05-03 |
| 1306318340 | Leah Margaret Hillier | Family Medicine | 1300 N 12th St - Suite 500, Phoenix, AZ 85006 | 2018-12-31 |
| 1326510389 | Leanne J Muniz | Family Medicine | 19635 N Cave Creek Rd Apt 344, Phoenix, AZ 85024-1879 | 2018-12-31 |
| 1164905535 | Clark Medical, Pllc | Family Medicine | 2601 N 3rd St Ste 106, Phoenix, AZ 85004-1144 | 2018-09-12 |
| 1780180901 | Babymoon Inn Family Care LLC | Family Medicine | 202 E Morris Dr, Phoenix, AZ 85012-2323 | 2018-04-05 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.