Individual provider Active NPI

Myrna Dorame, ALF OWNER

  • Assisted Living Facility
  • Tucson, AZ
National Provider Identifier
1194337568
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10039H Issued in AZ
Practice address
1532 S Perlman Ave
Tucson, AZ 85710-8523
Phone
(520) 393-9389
Fax
(520) 741-1465
NPI assigned
Aug 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10039H AZ Primary

Addresses

Primary practice location

1532 S Perlman Ave
Tucson, AZ 85710-8523

Mailing address

1532 S Perlman Ave
Tucson, AZ 85710-8523
Phone (520) 393-9389

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

LicenseStateTypeSpecialty
AL10039HAZMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1194337568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 S PERLMAN AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857108523",
            "telephone_number": "520-393-9389",
            "fax_number": "520-741-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 S PERLMAN AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857108523",
            "telephone_number": "520-393-9389",
            "fax_number": "520-741-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAME",
        "first_name": "MYRNA",
        "credential": "ALF OWNER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL10039H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.