Active NPI
Divine Nyamasoso Mukiza
- Driver
- Glendale, AZ
National Provider Identifier
1023725355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 16630 N 43Rd Ave Apt 267
Glendale, AZ 85306-1543 - Phone
- (319) 383-9411
- NPI assigned
- Nov 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Primary |
Addresses
Primary practice location
16630 N 43Rd Ave Apt 267
Glendale, AZ 85306-1543
Mailing address
16630 N 43Rd Ave Apt 267
Glendale, AZ 85306-1543
Phone (319) 383-9411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy One Transport | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Non-emergency Medical Transport (VAN)
- Iowa City, IA
- NPI 1295626281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667779200000",
"number": "1023725355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16630 N 43RD AVE APT 267",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853061543",
"telephone_number": "319-383-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16630 N 43RD AVE APT 267",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853061543",
"telephone_number": "319-383-9411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKIZA",
"first_name": "DIVINE",
"middle_name": "NYAMASOSO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-07",
"last_updated": "2022-11-07",
"certification_date": "2022-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.