Individual provider Active NPI

Tiffany Joanne Maravilla, RN

  • Registered Nurse
  • Aurora, CO
National Provider Identifier
1750110367
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1690116 Issued in CO
Practice address
1700 Wheeling St
Aurora, CO 80045-7211
Phone
(303) 399-8020
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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 1690116 CO Primary

Addresses

Primary practice location

1700 Wheeling St
Aurora, CO 80045-7211

Mailing address

9737 Jefferson Pkwy Apt 11F2
Englewood, CO 80112-7018
Phone (224) 243-0252

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1690116COMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1750110367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9737 JEFFERSON PKWY APT 11F2",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801127018",
            "telephone_number": "224-243-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WHEELING ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457211",
            "telephone_number": "303-399-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAVILLA",
        "first_name": "TIFFANY",
        "middle_name": "JOANNE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1690116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.