NPIMap

Organization Active NPI

Villa Maria Care Center, LLC

  • Skilled Nursing Facility
  • Tucson, AZ
National Provider Identifier
1902953813
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCI263 Issued in AZ
Legal business name
VILLA MARIA CARE CENTER, LLC
Practice address
4310 E Grant Rd
Tucson, AZ 85712-2607
Phone
(602) 368-8203
Fax
(602) 368-8211
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Authorized official

Name
Terry McNellis
Title
Owner
Phone
(612) 991-9062

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X ALC4564 AZ
Skilled Nursing Facility 314000000X NCI263 AZ Primary

Addresses

Primary practice location

4310 E Grant Rd
Tucson, AZ 85712-2607

Mailing address

4310 E Grant Rd
Tucson, AZ 85712-2607
Phone (520) 323-9351

Other identifiers 2

IdentifierTypeStateIssuer
618324MedicaidAZ
566292MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1902953813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122607",
            "telephone_number": "520-323-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122607",
            "telephone_number": "602-368-8203",
            "fax_number": "602-368-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA MARIA CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "MCNELLIS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-991-9062"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALC4564",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "618324",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "566292",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.