Individual provider Active NPI

Mary Jane Zdyrski

  • School Registered Nurse
  • Tucson, AZ
National Provider Identifier
1992318612
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN173438 Issued in AZ
Practice address
4455 S Mission Rd
Tucson, AZ 85746-4014
Phone
(520) 877-2017
Fax
(520) 877-2021
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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 RN173438 AZ Primary

Addresses

Primary practice location

4455 S Mission Rd
Tucson, AZ 85746-4014

Mailing address

4455 S Mission Rd
Tucson, AZ 85746-4014
Phone (520) 877-2017

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
RN173438AZMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1992318612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 S MISSION RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857464014",
            "telephone_number": "520-877-2017",
            "fax_number": "520-877-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 S MISSION RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857464014",
            "telephone_number": "520-877-2017",
            "fax_number": "520-877-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDYRSKI",
        "first_name": "MARY",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN173438",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 24, 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.

Verify at the official NPI Registry.