TUCSON CONCUSSION CENTER LLC (NPI# 1114306917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114306917 |
| Entity Type | Organization |
| Organization Name | TUCSON CONCUSSION CENTER LLC |
| Practice Address |
5199 E Farness Dr Suite 101 Tucson AZ 85712-2134 |
| Mailing Address |
5199 East Farness Suite 101 Tucson AZ 85712-2134 |
| Practice Telephone | 8448226824 |
| Mailing Telephone | 5206209100 |
| Mailing Fax Number | 8448226824 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-11-25 |
| Authorized Official Name | DR. HIRSCH HANDMAKER (CHAIRMAN/CEO) |
| Authorized Official Telephone | 3102592090 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
Eye and Vision Services Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 207QA0000X |
Family Medicine Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
5199 E FARNESS DR SUITE 101 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85712-2134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104950 | Nancy Rae Klug | Registered Nurse | 2380 N Ferguson Ave., Tucson, AZ 85712 | 2020-08-12 |
| 1013525534 | James Tutu Fiske I | Nurse Practitioner | 5700 E. Pima Street Suite C., Tucson, AZ 85712 | 2020-07-21 |
| 1063031953 | Mehera Tiffanie Hormuz | Student in an Organized Health Care Education/Training Program | 5301 E. Grant Rd., Tucson, AZ 85712 | 2020-04-10 |
| 1770133282 | Elizabeth Nadeschzda Lowell | Nurse Practitioner | 4881 E Grant Road, Suite 101, Tucson, AZ 85712 | 2019-09-17 |
| 1174185649 | Pisa Asc Holdco LLC | Clinic/Center | 4741 E Camp Lowell Drive, Tucson, AZ 85712 | 2019-07-03 |
| 1548821838 | Painted Sky Healthcare, Inc. | Hospice Care, Community Based | 2980 N Swan Rd Ste 222, Tucson, AZ 85712 | 2019-06-26 |
| 1558925644 | Helen Jane Lyall | Registered Nurse | Tucson Medical Centre, 5301 E Grant Road, Tucson, AZ 85712 | 2019-04-24 |
| 1760953541 | Anna Marissa Ramirez | Nurse Practitioner | 5170 E Glenn St Ste 160, Tucson, AZ 85712 | 2018-12-05 |
| 1407343841 | Imran Ata Md Pllc | Internal Medicine | 3925 E Fort Lowell Rd Ste 105, Tucson, AZ 85712 | 2018-04-20 |
| 1003322926 | Millennium Acupuncture | Acupuncturist | 6161 E Pima St Tucson Az 85712, Apt 2074, Tucson, AZ 85712 | 2017-12-15 |
| Find all providers in zip 85712 | ||||
| Taxonomy Code | 207QA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adolescent Medicine |
| A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730118449 | Shanti R Martinez-aksamit | Family Medicine | 13101 N Oracle Rd, Tucson, AZ 85739-9554 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386267078 | Aligned Medical Providers, LLC | Family Medicine | 9821 N 95th St, Scottsdale, AZ 85258-4589 | 2020-05-28 |
| 1083088173 | Compassionate Care Centers LLC | Family Medicine | 4494 W Peoria Ave, Suite 115a, Glendale, AZ 85302-2023 | 2015-11-30 |
| 1417211632 | Preet Gurinder Kaur Mangat | Family Medicine | 1492 S. Mill Ave, Suite No. 312, Tempe, AZ 85281 | 2012-07-03 |
| 1659694156 | Aspen Rae LLC | Family Medicine | 21681 N 77th Ave, Suite 1415, Peoria, AZ 85382-2132 | 2010-03-11 |
| 1629301734 | District Medical Group, Inc | Family Medicine | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2009-09-09 |
| 1285818948 | James B Vogt Md P.C. | Family Medicine | 5425 E Bell Rd, Suite 125, Scottsdale, AZ 85254-6007 | 2007-12-18 |
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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.