Active NPI
Alexis P Lucero, CHW
- Community Health Worker
- Gallup, NM
National Provider Identifier
1013852979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- G-2036
- Practice address
- 2111 College Dr
Gallup, NM 87301-5600 - Phone
- (505) 397-5172
- NPI assigned
- Apr 20, 2026
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | G-2036 | NM | Primary |
Addresses
Primary practice location
2111 College Dr
Gallup, NM 87301-5600
Mailing address
2111 College Dr
Gallup, NM 87301-5600
Phone (505) 397-5172
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 |
|---|---|---|---|
| G-2036 | NM | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776643200000",
"number": "1013852979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 COLLEGE DR",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015600",
"telephone_number": "505-397-5172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2111 COLLEGE DR",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015600",
"telephone_number": "505-397-5172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO",
"first_name": "ALEXIS",
"middle_name": "P",
"credential": "CHW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-20",
"last_updated": "2026-04-20",
"certification_date": "2026-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Community Health Worker",
"state": "NM",
"license": "G-2036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.