Active NPI
Justin Wayne Vanscoder
- Registered Nurse
- Florence, AZ
National Provider Identifier
1578063905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN210742
- Practice address
- 8047 W Georgetown Way
Florence, AZ 85132-6864 - Phone
- (760) 693-9712
- NPI assigned
- Feb 12, 2018
- Last updated
- Feb 12, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN210742 | AZ | Primary |
Addresses
Primary practice location
8047 W Georgetown Way
Florence, AZ 85132-6864
Mailing address
8047 W Georgetown Way
Florence, AZ 85132-6864
Phone (760) 693-9712
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 |
|---|---|---|---|
| RN210742 | AZ | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518393600000",
"number": "1578063905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8047 W GEORGETOWN WAY",
"city": "FLORENCE",
"state": "AZ",
"postal_code": "851326864",
"telephone_number": "760-693-9712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8047 W GEORGETOWN WAY",
"city": "FLORENCE",
"state": "AZ",
"postal_code": "851326864",
"telephone_number": "760-693-9712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANSCODER",
"first_name": "JUSTIN",
"middle_name": "WAYNE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-02-12",
"last_updated": "2018-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AZ",
"license": "RN210742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, AZ
- Tusa Ntabo Behavioral Health Services LLC
- U Medical PLLC
- Susan Underwood, LPC
- Valley Respite and Home Care LLC (Siara Assisted Living Home II)
- Valley Respite and Home Care LLC (Siara Assisted Living Home)
- Louis Eduardo Velasco III, M.D.
- Natasha Marie Wagner, LPC
- Robert C Wakefield, PA-C
- Deborah Walker, MS, OTR/L
- Mary L Walker, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.