Active NPI
Susan Marita
- Respite Care
- Mesa, AZ
National Provider Identifier
1376090761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Respite Care
- License
- BH4950
- Practice address
- 7335 E June St
Mesa, AZ 85207-2959 - Phone
- (602) 427-8235
- NPI assigned
- Sep 2, 2016
- 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 |
|---|---|---|---|---|
| Respite Care | 385H00000X | BH4950 | AZ | Primary |
Addresses
Primary practice location
7335 E June St
Mesa, AZ 85207-2959
Mailing address
7335 E June St
Mesa, AZ 85207-2959
Phone (602) 427-8235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BH4950 | Other | AZ | AZ DHS 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 |
|---|---|---|---|
| BH4950 | AZ | MD | Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1376090761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7335 E JUNE ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852072959",
"telephone_number": "602-427-8235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7335 E JUNE ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852072959",
"telephone_number": "602-427-8235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARITA",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-02",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "AZ",
"license": "BH4950",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ DHS LICENSE",
"identifier": "BH4950",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.