Individual provider Active NPI

Milada Tichy, FNP-C

  • Family Nurse Practitioner
  • Murray, UT
National Provider Identifier
1326222175
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
52324934405 Issued in UT
Practice address
5848 S 300 E
Murray, UT 84107-6157
Phone
(801) 314-4100
NPI assigned
Dec 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 52324934405 UT Primary
Family Nurse Practitioner 363LF0000X 5232493-4405 UT

Addresses

Primary practice location

5848 S 300 E
Murray, UT 84107-6157

Mailing address

7777 S Redwood Rd
West Jordan, UT 84084-5518
Phone (801) 255-9077

Other practice location 1

7777 S Redwood Rd
West Jordan, UT 84084-5518
Phone (801) 255-9077

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5232493-4405UTMDFamily Nurse Practitioner
52324934405UTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1326222175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 S REDWOOD RD",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845518",
            "telephone_number": "801-255-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 S 300 E",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076157",
            "telephone_number": "801-314-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 S Redwood Rd",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840845518",
            "country_code": "US",
            "telephone_number": "801-255-9077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TICHY",
        "first_name": "MILADA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "52324934405",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5232493-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.