Cynthia Shaw Ivan, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

630269 Issued in TX

Practice address

1545 Goodyear Dr
El Paso, TX 79936-6063

Phone

(915) 280-4684

Fax

(915) 534-3043

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Premier Medical Supply, LLC

  • Durable Medical Equipment & Medical Supplies
  • El Paso, TX
  • NPI 1467730366
  NPD (past)
• Samsara Healthcare PLLC

  • Multi-Specialty Clinic/Center
  • El Paso, TX
  • NPI 1669010815
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1205936689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 GOODYEAR DR STE D",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366063",
            "telephone_number": "915-280-4684",
            "fax_number": "915-594-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 GOODYEAR DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366063",
            "telephone_number": "915-280-4684",
            "fax_number": "915-534-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVAN",
        "first_name": "CYNTHIA",
        "middle_name": "SHAW",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "630269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Issa Institute for Holistic Health, PLLC
• Mariam Issa
• Isuani Radiology, P.a.
• Hugo E Isuani, MD
• Dolores Annette Ituarte Valenzuela, LPC
• January Dawn Ivancic
• Ivonne Barrera Counseling and Education Services
• Roy Ivy Jr., M.D.
• Femi David Iwaloye, M.D.
• Nicholas Iwata

• Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.