Active NPI
Vivian Seville, CNA, LMT
- Specialist
- Pine, AZ
National Provider Identifier
1992986640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MT-02072P
- Practice address
- 6152 W. Hardscrabble Road
Pine, AZ 85544 - Phone
- (928) 978-2618
- Fax
- (928) 476-3186
- NPI assigned
- Nov 23, 2007
- Last updated
- Nov 23, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MT-02072P | AZ | Primary |
Addresses
Primary practice location
6152 W. Hardscrabble Road
Pine, AZ 85544
Mailing address
PO Box 2453
Pine, AZ 85544-2453
Phone (928) 978-2618
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT-02072P | AZ | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195776000000",
"number": "1992986640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2453",
"city": "PINE",
"state": "AZ",
"postal_code": "855442453",
"telephone_number": "928-978-2618",
"fax_number": "928-476-3186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6152 W. HARDSCRABBLE ROAD",
"city": "PINE",
"state": "AZ",
"postal_code": "85544",
"telephone_number": "928-978-2618",
"fax_number": "928-476-3186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVILLE",
"first_name": "VIVIAN",
"credential": "CNA, LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-23",
"last_updated": "2007-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AZ",
"license": "MT-02072P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.