Individual provider Active NPI

Maria Sara Villa, RN

  • Lactation Consultant (Registered Nurse)
  • Tucson, AZ
National Provider Identifier
1457966012
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
177574 Issued in AZ
Practice address
102 N Plumer Ave
Tucson, AZ 85719-5906
Phone
(520) 225-3262
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 177574 AZ
Lactation Consultant (Registered Nurse) 163WL0100X 177574 AZ Primary

Addresses

Primary practice location

102 N Plumer Ave
Tucson, AZ 85719-5906

Mailing address

2804 E Malvern St
Tucson, AZ 85716-5615
Phone (520) 310-5631

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
177574AZMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1457966012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 E MALVERN ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165615",
            "telephone_number": "520-310-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N PLUMER AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857195906",
            "telephone_number": "520-225-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "MARIA",
        "middle_name": "SARA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "177574",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "AZ",
            "license": "177574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.