Active NPI
Ivonne Loren a Wadleigh
- Contractor
- Sahuarita, AZ
National Provider Identifier
1194989129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 874986
- Practice address
- 100 E Corte Rancho Colina
Sahuarita, AZ 85629-9061 - Phone
- (520) 207-1687
- NPI assigned
- Jul 18, 2008
- Last updated
- Jul 18, 2008
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 874986 | AZ | Primary |
Addresses
Primary practice location
100 E Corte Rancho Colina
Sahuarita, AZ 85629-9061
Mailing address
100 E Corte Rancho Colina
Sahuarita, AZ 85629-9061
Phone (520) 207-1687
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 874986 | Other | AZ | STATE OF AZ PFH LICENSE |
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 |
|---|---|---|---|
| 874986 | AZ | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216339200000",
"number": "1194989129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E CORTE RANCHO COLINA",
"city": "SAHUARITA",
"state": "AZ",
"postal_code": "856299061",
"telephone_number": "520-207-1687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E CORTE RANCHO COLINA",
"city": "SAHUARITA",
"state": "AZ",
"postal_code": "856299061",
"telephone_number": "520-207-1687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADLEIGH",
"first_name": "IVONNE",
"middle_name": "LOREN A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-18",
"last_updated": "2008-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "AZ",
"license": "874986",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF AZ PFH LICENSE",
"identifier": "874986",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sahuarita, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.