Active NPI
Koraima Morel Tirado
- General Practice Physician
- Lehi, UT
National Provider Identifier
1154973576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 87863
- Practice address
- 1035 W 190 S
Lehi, UT 84043-3833 - Phone
- (252) 292-0037
- NPI assigned
- Jul 15, 2019
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 87863 | PR | Primary |
Addresses
Primary practice location
1035 W 190 S
Lehi, UT 84043-3833
Mailing address
1035 W 190 S
Lehi, UT 84043-3833
Phone (252) 292-0037
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227885472 | Other | UT | DRIVERS LIC. |
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 |
|---|---|---|---|
| 87863 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563148800000",
"number": "1154973576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 W 190 S",
"city": "LEHI",
"state": "UT",
"postal_code": "840433833",
"telephone_number": "252-292-0037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 W 190 S",
"city": "LEHI",
"state": "UT",
"postal_code": "840433833",
"telephone_number": "252-292-0037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOREL TIRADO",
"first_name": "KORAIMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-15",
"last_updated": "2019-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "87863",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LIC.",
"identifier": "227885472",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lehi, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.