Individual provider Active NPI

Tiffany Kay Lage, LPN

  • Licensed Practical Nurse
  • Peoria, AZ
National Provider Identifier
1700018769
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP044259 Issued in AZ
Practice address
21233 N 79TH Dr
Peoria, AZ 85382-4454
Phone
(623) 313-2342
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP044259 AZ Primary

Addresses

Primary practice location

21233 N 79TH Dr
Peoria, AZ 85382-4454

Mailing address

21233 N 79TH Dr
Peoria, AZ 85382-4454
Phone (623) 313-2342

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
LP044259AZMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1700018769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21233 N 79TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853824454",
            "telephone_number": "623-313-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21233 N 79TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853824454",
            "telephone_number": "623-313-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGE",
        "first_name": "TIFFANY",
        "middle_name": "KAY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP044259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.