Individual provider Active NPI

Mary Ann Pratt

  • General Practice Registered Nurse
  • Hobbs, NM
National Provider Identifier
1154981249
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
CNP-02579 Issued in NM
Practice address
1123 E Green Acres Dr
Hobbs, NM 88240-4727
Phone
(806) 283-4548
NPI assigned
Jun 19, 2019
Last updated
Jun 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X CNP-02579 NM Primary

Addresses

Primary practice location

1123 E Green Acres Dr
Hobbs, NM 88240-4727

Mailing address

1123 E Green Acres Dr
Hobbs, NM 88240-4727
Phone (806) 283-4548

Other identifiers 1

IdentifierTypeStateIssuer
1538552070MedicaidNM

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

LicenseStateTypeSpecialty
CNP-02579NMMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1154981249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 E GREEN ACRES DR",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882404727",
            "telephone_number": "806-283-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 E GREEN ACRES DR",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882404727",
            "telephone_number": "806-283-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "MARY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NM",
            "license": "CNP-02579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538552070",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobbs, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.