Individual provider Active NPI

Marybeth Cleland, RN

  • School Registered Nurse
  • Prescott, AZ
National Provider Identifier
1972787463
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN144051 Issued in AZ
Practice address
1050 Ruth St
Prescott, AZ 86301-1730
Phone
(928) 445-2322
NPI assigned
Dec 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN144051 AZ Primary

Addresses

Primary practice location

1050 Ruth St
Prescott, AZ 86301-1730

Mailing address

697 Sesame St
Prescott, AZ 86305-3886
Phone (928) 445-0191

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
RN144051AZMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1972787463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 SESAME ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053886",
            "telephone_number": "928-445-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 RUTH ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011730",
            "telephone_number": "928-445-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLELAND",
        "first_name": "MARYBETH",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN144051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.