Daniel Matulac Badilla, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

777420 Issued in TX

Practice address

167 North Main St.
Tuba, AZ 86045

Phone

(928) 283-2501

NPI assigned

Jan 11, 2012

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 11, 2012.

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1326318031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 NORTH MAIN ST.",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "86045",
            "telephone_number": "928-283-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 NORTH MAIN ST.",
            "city": "TUBA",
            "state": "AZ",
            "postal_code": "86045",
            "telephone_number": "928-283-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADILLA",
        "first_name": "DANIEL",
        "middle_name": "MATULAC",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "777420",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001234638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Shane Cox, ARRT ( R ) , ARDMS
• Evelyn Nguyen
• Karen L Small, RN

• All providers in Tuba, AZ
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.