Kelly Van Pfeiffer

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

54573 Issued in NM

Practice address

3900 N Lovington Hwy Ste 550
Hobbs, NM 88240-1171

Phone

(575) 738-0051

Fax

(575) 291-3009

NPI assigned

Dec 30, 2018

Last updated

Apr 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Desert Functional Medicine & Aesthetics, LLC

  • Family Nurse Practitioner
  • Hobbs, NM
  • NPI 1528613924
  NPD Authorized official

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

{
    "created_epoch": "1546128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1003388190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 N LOVINGTON HWY STE 550",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882401171",
            "telephone_number": "575-964-8025",
            "fax_number": "575-291-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 N LOVINGTON HWY STE 550",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882401171",
            "telephone_number": "575-738-0051",
            "fax_number": "575-291-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFFER",
        "first_name": "KELLY",
        "middle_name": "VAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-30",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "54573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Perez, RN
• Tara Peterson
• Terrance Petties
• Keely Marie Pettus, COTA/L
• Stacy Peyton
• Debra Morgan Pieper, BHA, MBA
• Trinica Pigott
• Lorraine Aurora Pineda
• Bayleigh Pipkin
• Janie Pointer, LMSW

• Family Nurse Practitioner in Hobbs, NM
• Providers in Hobbs, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.