Individual provider Active NPI

Ashley Mediavilla Nieves

  • Registered Nurse
  • Bayamon, PR
National Provider Identifier
1639737448
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
83335 Issued in PR
Practice address
Urb Santa Cruz
B7 Calle Santa Cruz
Bayamon, PR 00961-6904
Phone
(787) 780-9196
Fax
(787) 625-6124
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 83335 PR Primary

Addresses

Primary practice location

Urb Santa Cruz
B7 Calle Santa Cruz
Bayamon, PR 00961-6904

Mailing address

Urb Santa Cruz
B7 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 780-9196

Other identifiers 1

IdentifierTypeStateIssuer
83335OtherPRCOLEGIO DE ENFERMERIA DE PUERTO RICO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address administracion@secure.cdtgmsp.com Direct

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
83335PRMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1639737448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB SANTA CRUZ",
            "address_2": "B7 CALLE SANTA CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-780-9196",
            "fax_number": "787-625-6124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB SANTA CRUZ",
            "address_2": "B7 CALLE SANTA CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616904",
            "telephone_number": "787-780-9196",
            "fax_number": "787-625-6124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDIAVILLA NIEVES",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "83335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLEGIO DE ENFERMERIA DE PUERTO RICO",
            "identifier": "83335",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "administracion@secure.cdtgmsp.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Urb. Santa Cruz",
            "address_2": "B7 Calle Santa Cruz",
            "city": "Bayamon",
            "state": "PR",
            "country_code": "US",
            "postal_code": "009616904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.