Individual provider Active NPI

Victoria Elizabeth Bare, LPN

  • Licensed Practical Nurse
  • Phoenix, AZ
National Provider Identifier
1871149765
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP010751 Issued in AZ
Practice address
1718 W Vineyard Rd
Phoenix, AZ 85041-5804
Phone
(602) 232-4253
Fax
(602) 243-4969
NPI assigned
Aug 15, 2019
Last updated
Aug 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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 LP010751 AZ Primary

Addresses

Primary practice location

1718 W Vineyard Rd
Phoenix, AZ 85041-5804

Mailing address

1367 S Country Club Dr Unit 1057
Mesa, AZ 85210-5289
Phone (602) 550-5038

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
LP010751AZMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1871149765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 S COUNTRY CLUB DR UNIT 1057",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105289",
            "telephone_number": "602-550-5038",
            "fax_number": "602-243-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 W VINEYARD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415804",
            "telephone_number": "602-232-4253",
            "fax_number": "602-243-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARE",
        "first_name": "VICTORIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP010751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.