Individual provider Active NPI

Jill Fierro, FNP

  • Family Nurse Practitioner
  • Carlsbad, NM
National Provider Identifier
1104167477
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP02149 Issued in NM
Practice address
2402 W Pierce St
Ste 4a
Carlsbad, NM 88220-3537
Phone
(575) 234-9964
NPI assigned
Mar 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP02149 NM Primary

Addresses

Primary practice location

2402 W Pierce St
Ste 4a
Carlsbad, NM 88220-3537

Mailing address

2402 W Pierce St
Ste 4a
Carlsbad, NM 88220-3537
Phone (575) 234-9964

Other identifiers 1

IdentifierTypeStateIssuer
000T9592MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2016 through Jul 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP02149NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Health & Wellness, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1104167477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 W PIERCE ST",
            "address_2": "STE 4A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203537",
            "telephone_number": "575-234-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 W PIERCE ST",
            "address_2": "STE 4A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203537",
            "telephone_number": "575-234-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIERRO",
        "first_name": "JILL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP02149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000T9592",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

Verify at the official NPI Registry.