Individual provider Active NPI

Carlos Ariel Tita, RN, CDCES

  • Ambulatory Care Registered Nurse
  • Provo, UT
National Provider Identifier
1093649857
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
11290048-3102 Issued in UT
Practice address
589 S State St
Provo, UT 84606-5056
Phone
(801) 429-2000
Fax
(801) 429-2001
NPI assigned
Jun 9, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WD0400X 11290048-3102 UT
Ambulatory Women's Health Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0101X 11290048-3102 UT
Ambulatory Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP2201X 11290048-3102 UT Primary

Addresses

Primary practice location

589 S State St
Provo, UT 84606-5056

Mailing address

1778 W 950 S
Springville, UT 84663-3544

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

NPI Registry JSON

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

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1093649857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 W 950 S",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846633544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-429-2000",
            "fax_number": "801-429-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITA",
        "first_name": "CARLOS",
        "middle_name": "ARIEL",
        "credential": "RN, CDCES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "UT",
            "license": "11290048-3102",
            "primary": false
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "UT",
            "license": "11290048-3102",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "UT",
            "license": "11290048-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.