Individual provider Active NPI

Sylvia Anne Rife, FNP

  • Family Nurse Practitioner
  • Portales, NM
National Provider Identifier
1245292242
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-01941 Issued in NM
Practice address
42121 US Hwy 70
Portales, NM 88130-9347
Phone
(575) 356-6652
Fax
(575) 226-0099
NPI assigned
Apr 5, 2006
Last updated
Nov 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15702A ID
Family Nurse Practitioner 363LF0000X CNP-01941 NM Primary

Addresses

Primary practice location

42121 US Hwy 70
Portales, NM 88130-9347

Mailing address

PO Box 299
Portales, NM 88130-9347
Phone (575) 356-6652

Other identifiers 1

IdentifierTypeStateIssuer
84328533MedicaidNM

Other names 1

  • Sylvia Anne Ferguson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20070716000741 ID Practitioner - Nurse Practitioner 8921006834 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15702AIDMDFamily Nurse Practitioner
CNP-01941NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Rock Medical Center LLC CurrentSince Jan 6, 2022 Accepting new patients

Locations

919 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 425-6020

Organizations & group practices 1

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1245292242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881309347",
            "telephone_number": "575-356-6652",
            "fax_number": "575-226-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42121 US HWY 70",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881309347",
            "telephone_number": "575-356-6652",
            "fax_number": "575-226-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIFE",
        "first_name": "SYLVIA",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "15702A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-01941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84328533",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYLVIA",
            "last_name": "FERGUSON",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portales, NM

Sources for this page

Verify at the official NPI Registry.