Active NPI
Eva H Gomez, LPN
- Licensed Practical Nurse
- Tolleson, AZ
National Provider Identifier
1124797048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP049214
- Practice address
- 9401 W Garfield St
Tolleson, AZ 85353-1606 - Phone
- (623) 533-3969
- Fax
- (623) 936-0649
- NPI assigned
- Sep 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP049214 | AZ | Primary |
Addresses
Primary practice location
9401 W Garfield St
Tolleson, AZ 85353-1606
Mailing address
9401 W Garfield St
Tolleson, AZ 85353-1606
Phone (623) 533-3969
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 741589 | Other | AHCCCS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP049214 | AZ | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1124797048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9401 W GARFIELD ST",
"city": "TOLLESON",
"state": "AZ",
"postal_code": "853531606",
"telephone_number": "623-533-3969",
"fax_number": "623-936-0649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9401 W GARFIELD ST",
"city": "TOLLESON",
"state": "AZ",
"postal_code": "853531606",
"telephone_number": "623-533-3969",
"fax_number": "623-936-0649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "EVA",
"middle_name": "H",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-13",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AZ",
"license": "LP049214",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "741589",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Tolleson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.