Individual provider Active NPI

Carole Anne Maselli, LPN

  • Licensed Practical Nurse
  • Phoenix, AZ
National Provider Identifier
1598841074
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP034799 Issued in AZ
Practice address
10251 N 35TH Ave
Phoenix, AZ 85051-1305
Phone
(602) 995-9406
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP034799 AZ Primary

Addresses

Primary practice location

10251 N 35TH Ave
Phoenix, AZ 85051-1305

Mailing address

19007 N 69TH Ave
Glendale, AZ 85308-5765
Phone (623) 572-9080

Other identifiers 1

IdentifierTypeStateIssuer
736514MedicaidAZ

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

LicenseStateTypeSpecialty
LP034799AZMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1598841074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19007 N 69TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085765",
            "telephone_number": "623-572-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10251 N 35TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511305",
            "telephone_number": "602-995-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASELLI",
        "first_name": "CAROLE",
        "middle_name": "ANNE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP034799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "736514",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.