Maritess Todd, OWNER

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12278H Issued in AZ

Practice address

12422 N 88TH Dr
Peoria, AZ 85381-8172

Phone

(623) 200-9675

Fax

(623) 979-5187

NPI assigned

Dec 6, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1679284103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12422 N 88TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853818172",
            "telephone_number": "623-200-9675",
            "fax_number": "623-979-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12422 N 88TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853818172",
            "telephone_number": "623-200-9675",
            "fax_number": "623-979-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "MARITESS",
        "credential": "OWNER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL12278H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PEORIA",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12422 N 88th Dr",
            "city": "Peoria",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853818172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Assisted Living Facility in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.