Individual provider Active NPI

Michelle Leona Valdez, N.P.

  • Women's Health Nurse Practitioner
  • Alamosa, CO
National Provider Identifier
1114901931
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
78188 Issued in CO
Practice address
106 Blanca Ave
Alamosa, CO 81101-2340
Phone
(719) 589-8028
Fax
(719) 589-8086
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 78188 CO Primary

Addresses

Primary practice location

106 Blanca Ave
Alamosa, CO 81101-2340

Mailing address

77 Adcock Dr
Alamosa, CO 81101-8903
Phone (719) 589-2370

Other identifiers 2

IdentifierTypeStateIssuer
12050873MedicaidCO
P00294181OtherCOMEDICARE RAILROAD CARRIER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20050120000469 CO Practitioner - Nurse Practitioner 6204885817

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78188COMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Hospital Association of the San Luis Valley 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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1114901931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ADCOCK DR",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811018903",
            "telephone_number": "719-589-2370",
            "fax_number": "719-587-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BLANCA AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012340",
            "telephone_number": "719-589-8028",
            "fax_number": "719-589-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "MICHELLE",
        "middle_name": "LEONA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "78188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12050873",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00294181",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamosa, CO

Sources for this page

Verify at the official NPI Registry.