Individual provider Active NPI

Shana D Vazquez, RN

  • Registered Nurse
  • Fort Bliss, TX
National Provider Identifier
1285966507
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1114997 Issued in TX
Practice address
21227 Torch St
Ft Bliss, TX 79918
Phone
(915) 742-9232
NPI assigned
Feb 11, 2010
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1114997 TX Primary

Addresses

Primary practice location

21227 Torch St
Ft Bliss, TX 79918

Mailing address

13677 Glen Vista LN
Horizon City, TX 79928-6082
Phone (808) 778-3901

Other identifiers 1

IdentifierTypeStateIssuer
VADOOOtherUPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1114997TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1285966507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13677 GLEN VISTA LN",
            "city": "HORIZON CITY",
            "state": "TX",
            "postal_code": "799286082",
            "telephone_number": "808-778-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21227 TORCH ST",
            "city": "FT BLISS",
            "state": "TX",
            "postal_code": "79918",
            "telephone_number": "915-742-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "SHANA",
        "middle_name": "D",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-11",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1114997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "VADOO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bliss, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.