Active NPI
Maryam Jalila Davis, CERTIFIED NURSING AS
- Nurse's Aide
- Glendale, AZ
National Provider Identifier
1972132421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 1000048010
- Practice address
- 5150 N 99TH Ave Apt 3091
Glendale, AZ 85305-3034 - Phone
- (602) 516-5096
- NPI assigned
- Apr 6, 2020
- Last updated
- Apr 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 1000048010 | AZ | Primary |
| Respite Care | 385H00000X | NU | ||
| Child Mental Illness Respite Care | 385HR2055X | NU | ||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | NU | ||
| Child Physical Disabilities Respite Care | 385HR2065X | NU | ||
| Phlebotomy Technician | 246RP1900X | NU |
Addresses
Primary practice location
5150 N 99TH Ave Apt 3091
Glendale, AZ 85305-3034
Mailing address
5150 N 99TH Ave Apt 3091
Glendale, AZ 85305-3034
Phone (602) 516-5096
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
- Associate of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1000048010 | AZ | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586131200000",
"number": "1972132421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5150 N 99TH AVE APT 3091",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853053034",
"telephone_number": "602-516-5096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 N 99TH AVE APT 3091",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853053034",
"telephone_number": "602-516-5096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MARYAM",
"middle_name": "JALILA",
"credential": "CERTIFIED NURSING AS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-06",
"last_updated": "2020-04-06",
"certification_date": "2020-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "AZ",
"license": "1000048010",
"primary": true
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.