Active NPI
Iggy Mayboroda, N.D.
- Naturopath
- Gilbert, AZ
National Provider Identifier
1427323245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 099.0084660
- Practice address
- 4149 E Betsy LN
Gilbert, AZ 85296-9623 - Phone
- (480) 600-0807
- NPI assigned
- Mar 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 099.0084660 | VT | Primary |
| Naturopath | 175F00000X | ND-535 | CA |
Addresses
Primary practice location
4149 E Betsy LN
Gilbert, AZ 85296-9623
Mailing address
4149 E Betsy LN
Gilbert, AZ 85296-9623
Phone (480) 600-0807
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 099.0084660 | Other | VT | CREDENTIAL # |
| NDF-535 | Other | CA | STATE 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 |
|---|---|---|---|
| ND-535 | CA | MD | Naturopath |
| 099.0084660 | VT | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380672000000",
"number": "1427323245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4149 E BETSY LN",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852969623",
"telephone_number": "480-600-0807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4149 E BETSY LN",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852969623",
"telephone_number": "480-600-0807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYBORODA",
"first_name": "IGGY",
"name_prefix": "Dr.",
"credential": "N.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-12",
"last_updated": "2013-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "VT",
"license": "099.0084660",
"primary": true
},
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "CA",
"license": "ND-535",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CREDENTIAL #",
"identifier": "099.0084660",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "NDF-535",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.