Individual provider Active NPI

Malgorzata Chmura-Witusik, RN

  • Registered Nurse
  • Prescott, AZ
National Provider Identifier
1285274597
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
225896 Issued in AZ
Practice address
500 N US Highway 89
Prescott, AZ 86313-5001
Phone
(928) 445-4860
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 225896 AZ Primary

Addresses

Primary practice location

500 N US Highway 89
Prescott, AZ 86313-5001

Mailing address

1553 Eagle Point Dr
Prescott, AZ 86301-5450
Phone (773) 415-4949

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
225896AZMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1285274597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 EAGLE POINT DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015450",
            "telephone_number": "773-415-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N US HIGHWAY 89",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863135001",
            "telephone_number": "928-445-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHMURA-WITUSIK",
        "first_name": "MALGORZATA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "225896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.