Individual provider Active NPI

Tanya Marlene Azizi

  • Registered Nurse
  • Ann Arbor, MI
National Provider Identifier
1992219018
Registry record updated Nov 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704215171 Issued in MI
Practice address
828 Rose Dr
Ann Arbor, MI 48103-2175
Phone
(734) 546-5561
NPI assigned
Nov 28, 2017
Sex
Female
Sole proprietor
Yes

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
4704215171MIMDRegistered Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704215171 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

828 Rose Dr
Ann Arbor, MI 48103-2175

Mailing address

828 Rose Dr
Ann Arbor, MI 48103-2175

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 28, 2017.

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1992219018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 ROSE DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 ROSE DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032175",
            "telephone_number": "734-546-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIZI",
        "first_name": "TANYA",
        "middle_name": "MARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704215171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.