Active NPI
Supreme Nursing & Allied Professionals LLC
- Family Nurse Practitioner
- Vail, AZ
National Provider Identifier
1760195580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- SUPREME NURSING & ALLIED PROFESSIONALS LLC
- Practice address
- 10867 S Distillery Canyon Spring Dr
Vail, AZ 85641-2558 - Phone
- (520) 234-7776
- NPI assigned
- Dec 27, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Ann Jones, FNP-BC
- Title
- Owner
- Phone
- (520) 234-7776
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
10867 S Distillery Canyon Spring Dr
Vail, AZ 85641-2558
Mailing address
10867 S Distillery Canyon Spring Dr
Vail, AZ 85641-2558
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Tucson, AZ
- NPI 1295379964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672099200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1672099200000",
"number": "1760195580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10867 S DISTILLERY CANYON SPRING DR",
"city": "VAIL",
"state": "AZ",
"postal_code": "856412558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10867 S DISTILLERY CANYON SPRING DR",
"city": "VAIL",
"state": "AZ",
"postal_code": "856412558",
"telephone_number": "520-234-7776"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPREME NURSING & ALLIED PROFESSIONALS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-12-27",
"last_updated": "2022-12-27",
"certification_date": "2022-12-27",
"status": "A",
"authorized_official_last_name": "JONES",
"authorized_official_first_name": "MARY ANN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "520-234-7776",
"authorized_official_credential": "FNP-BC"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vail, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.