Guadalupe Ibanez Davila, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

74010 Issued in AZ

Practice address

1852 N Mastick Way
Nogales, AZ 85621-1063

Phone

(520) 281-1550

Fax

(520) 281-4487

NPI assigned

May 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: guadalupe.davila.p1@direct.azch.nextgenshare.com

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.

• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Nogales, AZ
  • NPI 1417985474

  Family Medicine

  Medicare reassignment NPD
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Patagonia, AZ
  • NPI 1003837618

  Family Medicine

  NPD
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Nogales, AZ
  • NPI 1487537445
  NPD
• HCH Tucson Holdings LLC

  • Critical Access Hospital
  • Nogales, AZ
  • NPI 1639555865
  NPD (past)
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tubac, AZ
  • NPI 1578922787

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1073196416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N GRAND AVE STE 100",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211061",
            "telephone_number": "520-761-2128",
            "fax_number": "520-281-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 N MASTICK WAY",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211063",
            "telephone_number": "520-281-1550",
            "fax_number": "520-281-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "GUADALUPE",
        "middle_name": "IBANEZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "74010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corazon Inc.
• Alva Leticia Corella, LPN
• Guy A Crawford, M.D.
• Sophia Alize Cuadras, RDH
• Fabiola G Cunningham, LCSW
• Nicholas Walker Deer, RN
• Leon Francis Deisering, CRNA
• Dependable Home Health, Inc
• Dependable Medical Equipment, Inc
• James Lyle Derickson, MD

• Pediatrics Physician in Nogales, AZ
• Providers in Nogales, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.