Active NPI
Marcella J Davis, LPN
- Student in an Organized Health Care Education/Training Program
- Surprise, AZ
National Provider Identifier
1629470539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- LP048622
- Practice address
- 17032 W Surprise Farms Loop S
Surprise, AZ 85388-1581 - Phone
- (623) 523-8640
- NPI assigned
- Sep 23, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | LP048622 | AZ | Primary |
Addresses
Primary practice location
17032 W Surprise Farms Loop S
Surprise, AZ 85388-1581
Mailing address
17311 W Ivy LN
Surprise, AZ 85388-1208
Phone (623) 256-6647
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 |
|---|---|---|---|
| LP048622 | AZ | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411430400000",
"number": "1629470539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17311 W IVY LN",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853881208",
"telephone_number": "623-256-6647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17032 W SURPRISE FARMS LOOP S",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853881581",
"telephone_number": "623-523-8640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MARCELLA",
"middle_name": "J",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-23",
"last_updated": "2014-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AZ",
"license": "LP048622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.