Individual provider Active NPI

Patricia J Taboga, R,N,

  • General Practice Registered Nurse
  • Douglas, WY
National Provider Identifier
1669796363
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN27828 Issued in WY
Practice address
1841 Madora Ave
Douglas, WY 82633-3057
Phone
(307) 358-2846
Fax
(307) 358-5329
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN27828 WY Primary

Addresses

Primary practice location

1841 Madora Ave
Douglas, WY 82633-3057

Mailing address

1841 Madora Ave
Douglas, WY 82633-3057
Phone (307) 358-3247

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
RN27828WYMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1669796363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 MADORA AVE",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826333057",
            "telephone_number": "307-358-3247",
            "fax_number": "307-358-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 MADORA AVE",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826333057",
            "telephone_number": "307-358-2846",
            "fax_number": "307-358-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOGA",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "credential": "R,N,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "WY",
            "license": "RN27828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.