Individual provider Active NPI

Encarnacion Q Mijares, NP-C

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1104962927
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
505076 Issued in TX
Practice address
7806 Gateway Blvd E
Ste 100
El Paso, TX 79915-1800
Phone
(915) 592-6868
Fax
(915) 592-6889
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 505076 TX Primary

Addresses

Primary practice location

7806 Gateway Blvd E
Ste 100
El Paso, TX 79915-1800

Mailing address

7806 Gateway Blvd E
Ste 100
El Paso, TX 79915-1800
Phone (915) 592-6868

Other identifiers 1

IdentifierTypeStateIssuer
505076OtherTXREGISTERED NURSE LICENSE

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
505076TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104962927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7806 GATEWAY BLVD E",
            "address_2": "STE 100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799151800",
            "telephone_number": "915-592-6868",
            "fax_number": "915-592-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7806 GATEWAY BLVD E",
            "address_2": "STE 100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799151800",
            "telephone_number": "915-592-6868",
            "fax_number": "915-592-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIJARES",
        "first_name": "ENCARNACION",
        "middle_name": "Q",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "505076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "505076",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.