Active NPI
Dorothy Plaza
- Diabetes Educator Registered Nurse
- Moscow, ID
National Provider Identifier
1124547401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- 50282
- Practice address
- 700 S Main St
Moscow, ID 83843-3056 - Phone
- (208) 883-6341
- NPI assigned
- Sep 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | 50282 | ID | Primary |
Addresses
Primary practice location
700 S Main St
Moscow, ID 83843-3056
Mailing address
916 E 7TH St
Moscow, ID 83843-3709
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50282 | ID | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505692800000",
"number": "1124547401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 E 7TH ST",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838433709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S MAIN ST",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838433056",
"telephone_number": "208-883-6341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLAZA",
"first_name": "DOROTHY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-18",
"last_updated": "2017-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "ID",
"license": "50282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.