Individual provider Active NPI

Lacy Ann Rodriguez, NP

  • Nurse Practitioner
  • Silver City, NM
National Provider Identifier
1013639830
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
69210 Issued in NM
Practice address
114 W 11TH St
Silver City, NM 88061-5136
Phone
(575) 388-1511
NPI assigned
Sep 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 69210 NM Primary

Addresses

Primary practice location

114 W 11TH St
Silver City, NM 88061-5136

Mailing address

1387 Bison Spring Dr
Las Cruces, NM 88012-5105
Phone (575) 574-8380

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221028001426 NM Practitioner - Nurse Practitioner 2668849944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cura HealthcareGroup PAC ID 5799143103, 81 clinicians

Practice addresses (Care Compare)

Albuquerque, NM 87110
Phone (505) 413-3719

Hospital & facility affiliations

  • Gila Regional Medical Center Hospital, Silver City, NM, CCN 321311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hidalgo Medical Services CurrentSince Oct 28, 2022 Accepting new patients
Hidalgo Medical Services Current Accepting new patients
Hidalgo Medical Services CurrentSince Oct 28, 2022 Accepting new patients
Cura Healthcare CurrentSince May 1, 2024 Accepting new patients

Locations

8226 Menaul Blvd NE
Albuquerque, NM 87110
Phone (505) 413-3719

530 De Moss St
Lordsburg, NM 88045
Phone (575) 542-2368

114 W 11th St
Silver City, NM 88061
Phone (575) 388-1511

1007 N Pope St
Silver City, NM 88061
Phone (575) 388-1511

7683 SE 27th St
Mercer Island, WA 98040
Phone (206) 228-8530

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1013639830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1387 BISON SPRING DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880125105",
            "telephone_number": "575-574-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W 11TH ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880615136",
            "telephone_number": "575-388-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LACY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "69210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

Verify at the official NPI Registry.