Charles Alan Vickrey, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R66418 Issued in NM

Practice address

5001 N Piedras St
El Paso, TX 79930-4210

Phone

(915) 564-6100

Fax

(915) 564-7951

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1104934116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 N PIEDRAS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799304210",
            "telephone_number": "915-564-6100",
            "fax_number": "915-564-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 N PIEDRAS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799304210",
            "telephone_number": "915-564-6100",
            "fax_number": "915-564-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKREY",
        "first_name": "CHARLES",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "691712",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R66418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delia Elisabeth Vicencio, MSPT
• Judith Vicencio, RSPS
• Manuel Alejandro Vicente, AUD
• Linda T Vick, L.C.S.W,
• Lindsey Vick, LVN
• Victor Gomez Vanval Enterprise
• Victor Ramirez Optometrist PC
• Victoria'S in-Home Care
• Kirk Lance Victorian, CRNA
• Victory Counseling Center, Inc.

• Family Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.