Individual provider Active NPI

Jennifer Lynn Matherly, CNM

  • Advanced Practice Midwife
  • Las Cruces, NM
National Provider Identifier
1063844017
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
663 Issued in NM
Practice address
4351 E Lohman Ave Ste 401
Las Cruces, NM 88011-8261
Phone
(575) 522-4767
Fax
(575) 522-3607
NPI assigned
Aug 1, 2013
Last updated
Sep 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 663 NM Primary

Addresses

Primary practice location

4351 E Lohman Ave Ste 401
Las Cruces, NM 88011-8261

Mailing address

4351 E Lohman Ave Ste 401
Las Cruces, NM 88011-8261
Phone (575) 522-4767

Other identifiers 1

IdentifierTypeStateIssuer
42876826MedicaidNM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer.matherly.1@1928.direct.athenahealth.com

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131203001983 NM Practitioner - Certified Nurse Midwife (CNM) 5395971915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as apm
Quality
79.07
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Las Cruces Physician Practices, LLC Current Accepting new patients
Las Cruces Physician Services LLC CurrentSince Jan 1, 2020 Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Jul 11, 2016 Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Jul 11, 2016 Accepting new patients
Women's Specialists of New Mexico Past Accepting new patients
Las Cruces Medical Center LLC Past Accepting new patients
Familycare Associates,PA Past Accepting new patients

Locations

1135 S Main St
Ste B
Las Cruces, NM 88005
Phone (505) 522-5205

2520 S Telshor Blvd
Las Cruces, NM 88011
Phone (575) 522-9793

4351 E Lohman Ave
Ste 200
Las Cruces, NM 88011
Phone (505) 532-9755

4351 E Lohman Ave
Ste 401
Las Cruces, NM 88011
Phone (505) 522-4767

4351 E Lohman Ave
Ste 403
Las Cruces, NM 88011
Phone (575) 522-6806

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.779

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1063844017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE STE 401",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118261",
            "telephone_number": "575-522-4767",
            "fax_number": "575-522-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE STE 401",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118261",
            "telephone_number": "575-522-4767",
            "fax_number": "575-522-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERLY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42876826",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.matherly.1@1928.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "4351 E Lohman Ave Ste 401",
            "city": "Las Cruces",
            "state": "NM",
            "country_code": "US",
            "postal_code": "880118261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.