Individual provider Active NPI

Theresa Lanika Malone

  • Registered Nurse
  • Sierra Vista, AZ
National Provider Identifier
1679458772
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN208203 Issued in AZ
Practice address
2401 Meadowlark Dr
Sierra Vista, AZ 85635-3457
Phone
(520) 678-1734
NPI assigned
Aug 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X RN208203 AZ Primary

Addresses

Primary practice location

2401 Meadowlark Dr
Sierra Vista, AZ 85635-3457

Mailing address

2401 Meadowlark Dr
Sierra Vista, AZ 85635-3457
Phone (520) 678-1734

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
RN208203AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Vida Feliz Care Agency LLC CurrentSince Aug 10, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1679458772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 MEADOWLARK DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353457",
            "telephone_number": "520-678-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 MEADOWLARK DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353457",
            "telephone_number": "520-678-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "THERESA",
        "middle_name": "LANIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN208203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.