Individual provider Active NPI

Genevieve Jo Gutierrez Davis, APRN

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1174045520
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-77765 Issued in KS
Practice address
500 Walter St NE Ste 401
Albuquerque, NM 87102-2563
Phone
(316) 689-9111
NPI assigned
Jul 7, 2017
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 53-77765 KS Primary

Addresses

Primary practice location

500 Walter St NE Ste 401
Albuquerque, NM 87102-2563

Mailing address

4101 Indian School Rd NE Ste 110
Albuquerque, NM 87110-3991
Phone (505) 727-7833

Other names 1

  • Ms. Genevieve Jo Gutierrez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180416001475 NY Practitioner - Nurse Practitioner 6507136363 Reassigns benefits to 1 organization
I20210423000237 NM Practitioner - Nurse Practitioner 6507136363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

4705 Montgomery Blvd NE
Suite 201
Albuquerque, NM 87109-1233
Phone (505) 727-7833

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-77765KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Jun 14, 2021 Accepting new patients
Albany Medical College CurrentSince Mar 19, 2018 Accepting new patients
Albany Medical College CurrentSince Mar 19, 2018 Accepting new patients
Albany Medical College CurrentSince Jul 1, 2020 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jun 14, 2021 Accepting new patients
Albany Medical College Current Accepting new patients

Locations

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

4705 Montgomery Blvd NE
Ste 102
Albuquerque, NM 87109
Phone (505) 727-7833

4705 Montgomery Blvd NE
Ste 201
Albuquerque, NM 87109
Phone (505) 727-6550

500 Walter St NE
Ste 401
Albuquerque, NM 87102
Phone (505) 727-5910

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
Menands, NY 12204
Phone (518) 262-9705

Interoperability endpoints

  • Direct secure messaging: gdavis354883@ahs.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1174045520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 INDIAN SCHOOL RD NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103991",
            "telephone_number": "505-727-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE STE 401",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022563",
            "telephone_number": "316-689-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GENEVIEVE",
        "middle_name": "JO GUTIERREZ",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENEVIEVE",
            "last_name": "GUTIERREZ",
            "middle_name": "JO",
            "prefix": "MS.",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.