Individual provider Active NPI

Alvenia Murray

  • Family Nurse Practitioner
  • Fort Irwin, CA
National Provider Identifier
1174281208
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9519204 Issued in CA
Practice address
390 N Loop Road
Fort Irwin, CA 92310
Phone
(573) 586-8238
NPI assigned
Dec 6, 2021
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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 9519204 CA Primary

Addresses

Primary practice location

390 N Loop Road
Fort Irwin, CA 92310

Mailing address

PO Box 10734
Fort Irwin, CA 92310-0734
Phone (573) 586-8238

Other identifiers 1

IdentifierTypeStateIssuer
95019204OtherCANURSE PRACTITIONER LICENSURE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230731003113 CA Practitioner - Nurse Practitioner 0749641215 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9519204CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Health Partners, Inc CurrentSince Jul 1, 2023 Accepting new patients
Shiloh Medical Center Inc CurrentSince Jul 1, 2023 Accepting new patients

Locations

12984 Hesperia Rd
Ste 101
Victorville, CA 92395
Phone (760) 243-4009

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1174281208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10734",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923100734",
            "telephone_number": "573-586-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N LOOP ROAD",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "92310",
            "telephone_number": "573-586-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "ALVENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "9519204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSURE",
            "identifier": "95019204",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Irwin, CA

Sources for this page

Verify at the official NPI Registry.