TAD PALMER DEWALD (NPI# 1811258130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811258130 |
| Entity Type | Individual |
| Full Name | TAD PALMER DEWALD |
| Practice Address |
5301 E Grant Rd Tucson AZ 85712-2805 |
| Mailing Address |
Po Box 31630 Tucson AZ 85751-1630 |
| Practice Telephone | 5207846200 |
| Practice Fax Number | 5207846109 |
| Mailing Telephone | (520) 784-6200 |
| Mailing Fax Number | 5207846109 |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
54466 | AZ | Allopathic & Osteopathic Physicians |
| N | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
MD.35418 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 279012 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 805 Saint Vincents Dr, Suite 100, Birmingham, AL 352051636 | 2459393699 | 2055817155 |
| Street Address |
5301 E GRANT RD |
| City | TUCSON |
| State | AZ |
| Zip Code | 85712-2805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013910157 | Coleman Wade Davidson II | Obstetrics & Gynecology | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2005-05-23 |
| 1134720501 | Rosalee Valdivia Blair | Pharmacist | 5301 E Grant Rd, Tucson, AZ 85712-2874 | 2020-11-03 |
| 1811509383 | Julia Jennifer Ni | Registered Nurse | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2020-08-17 |
| 1295345759 | Myriam Raquel Hanna | Physical Therapist | 5301 E Grant Rd, Tucson, AZ 85712-2874 | 2020-08-08 |
| 1104443134 | Carlos Venancio Bejarano | Student in an Organized Health Care Education/Training Program | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2020-06-25 |
| 1326664566 | Michelle Skrzelowski | Student in an Organized Health Care Education/Training Program | 5301 E Grant Rd, Tucson, AZ 85712-2874 | 2020-06-23 |
| 1295351591 | Chloe Evelyn Williams | Student in an Organized Health Care Education/Training Program | 5301 E Grant Rd, Tucson, AZ 85712-2874 | 2020-06-23 |
| 1790301901 | Raveena Kaur Brar | Student in an Organized Health Care Education/Training Program | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2020-06-23 |
| 1043835333 | Danielle Monique Anderson | Pharmacist | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2020-06-11 |
| 1336764927 | Brandon Pike | Student in an Organized Health Care Education/Training Program | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2020-06-10 |
| Find all providers in the same location | ||||
| 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 | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386173748 | Aliesje Nichole Thrower | Physical Medicine & Rehabilitation | 8465 E Hodgman Pl, Tucson, AZ 85747 | 2017-06-08 |
| 1194167858 | Rejuv Medical Southwest Corp | Physical Medicine & Rehabilitation | 7790 N Oracle Rd, Suite 150, Tucson, AZ 85704-6579 | 2013-07-23 |
| 1093273526 | Bridgette Darton | Physical Medicine & Rehabilitation | 1991 E Ajo Way Ste 149, Tucson, AZ 85713-6269 | 2019-03-04 |
| 1174050058 | Jill Floryance | Physical Medicine & Rehabilitation | 4821 N Stone Ave, Tucson, AZ 85704-5727 | 2017-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233785 | Tara Anne Condon | Physical Medicine & Rehabilitation | 3300 W Camelback Rd Bldg 12, Phoenix, AZ 85017-3030 | 2019-06-12 |
| 1528556495 | Stone Med, LLC | Physical Medicine & Rehabilitation | 77 S Dobson Rd., Phoenix, AZ 85224 | 2018-04-26 |
| 1801390885 | Melissa Abellanida | Physical Medicine & Rehabilitation | 9127 W Thunderbird Rd Ste 101, Peoria, AZ 85381-4887 | 2018-03-22 |
| 1366622466 | Jonathan David Tait | Physical Medicine & Rehabilitation | 7790 N Oracle Rd Ste 150, Suite 150, Oro Valley, AZ 85704-6589 | 2007-11-06 |
| 1245455666 | David Iannicca | Physical Medicine & Rehabilitation | 15946 N Bullard Ave, Surprise, AZ 85374-8844 | 2007-04-13 |
| 1659402998 | East Valley Spine and Sports Medicine Center, Plc | Physical Medicine & Rehabilitation | 4858 E Baseline Rd, Suite 107, Mesa, AZ 85206-4638 | 2007-03-08 |
| 1821141250 | Sholom Gootzeit | Physical Medicine & Rehabilitation | 17233 N Holmes Blvd Ste 1640, 13761 W. Bell Road, Suite 203, Surprise, Az 85374, Phoenix, AZ 85053-2020 | 2007-01-19 |
| 1497728372 | Michael G. Crincoli | Physical Medicine & Rehabilitation | 1012 East Willetta Street, Phoenix, AZ 85006 | 2006-02-09 |
| 1457910416 | George Hackett | Physical Medicine & Rehabilitation | 3300 W Camelback Rd, Phoenix, AZ 85017-1097 | 2019-06-12 |
| 1194384172 | Rachael Marie Bode | Physical Medicine & Rehabilitation | 3300 W Camelback Rd, Phoenix, AZ 85017-3030 | 2019-06-12 |
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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.