Individual provider Active NPI

Diane Davies, R.N.

  • Community Health Registered Nurse
  • Tooele, UT
National Provider Identifier
1407047301
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
224510-3102 Issued in UT
Practice address
151 N Main St
Tooele, UT 84074-2141
Phone
(435) 843-2368
Fax
(435) 843-2304
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 224510-3102 UT Primary

Addresses

Primary practice location

151 N Main St
Tooele, UT 84074-2141

Mailing address

151 N Main St
Tooele, UT 84074-2141
Phone (435) 843-2368

Other identifiers 1

IdentifierTypeStateIssuer
998877663001MedicaidUT

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
224510-3102UTMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1407047301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742141",
            "telephone_number": "435-843-2368",
            "fax_number": "435-843-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742141",
            "telephone_number": "435-843-2368",
            "fax_number": "435-843-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "DIANE",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "UT",
            "license": "224510-3102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "998877663001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.