Individual provider Active NPI

Guy Massena

  • Community Health Registered Nurse
  • Clovis, NM
National Provider Identifier
1063806594
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
R54346 Issued in NM
Practice address
1100 W 21St St
Clovis, NM 88101-4151
Phone
(575) 769-2345
Fax
(575) 769-9013
NPI assigned
Mar 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R54346 NM
Community Health Registered Nurse 163WC1500X R54346 NM Primary

Addresses

Primary practice location

1100 W 21St St
Clovis, NM 88101-4151

Mailing address

1100 W 21St St
Clovis, NM 88101-4151
Phone (575) 769-2345

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
R54346NMMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1063806594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014151",
            "telephone_number": "575-769-2345",
            "fax_number": "575-769-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014151",
            "telephone_number": "575-769-2345",
            "fax_number": "575-769-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENA",
        "first_name": "GUY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R54346",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NM",
            "license": "R54346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.