Active NPI
Del Mercer Internal Medicine Ag-Acnp LLC
- Gerontology Nurse Practitioner
- Las Cruces, NM
National Provider Identifier
1255017174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- Legal business name
- DEL MERCER INTERNAL MEDICINE AG-ACNP LLC
- Practice address
- 2801 Missouri Ave Ste. 12
Las Cruces, NM 88011 - Phone
- (575) 522-6900
- Fax
- (575) 522-8891
- NPI assigned
- Jun 26, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Del Mercer, CNP
- Title
- Officer
- Phone
- (575) 636-3208
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | Primary |
Addresses
Primary practice location
2801 Missouri Ave Ste. 12
Las Cruces, NM 88011
Mailing address
PO Box 56
Mesilla Park, NM 88047
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230712004046 | NM | Part B Supplier - Clinic/Group Practice | 4486014164 |
Receives reassigned benefits from 1 practitioner Practice locations: Las Cruces, NM |
National Provider Directory
National Provider DirectoryLocations
5065 McNutt Rd
Santa Teresa, NM 88008
Phone (505) 589-0033
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Las Cruces, NM
- NPI 1811913502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687737600000",
"number": "1255017174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 56",
"city": "MESILLA PARK",
"state": "NM",
"postal_code": "88047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 MISSOURI AVE STE. 12",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "88011",
"telephone_number": "575-522-6900",
"fax_number": "575-522-8891"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DEL MERCER INTERNAL MEDICINE AG-ACNP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-26",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A",
"authorized_official_last_name": "MERCER",
"authorized_official_first_name": "DEL",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "575-636-3208",
"authorized_official_credential": "CNP"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.