Individual provider Active NPI

Mariah Mthembu

  • Student in an Organized Health Care Education/Training Program
  • Tucson, AZ
National Provider Identifier
1083359343
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
R79479 Issued in AZ
Practice address
1501 N Campbell Ave
Tucson, AZ 85724-0001
Phone
(520) 626-7399
NPI assigned
May 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R79479 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-0001

Mailing address

PO Box 245073
Tucson, AZ 85724-5073

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220706003426 AZ Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4587044623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1083359343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 245073",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857245073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857240001",
            "telephone_number": "520-626-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MTHEMBU",
        "first_name": "MARIAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R79479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.