Individual provider Active NPI

Dolores Cordova, CFNP

  • Family Nurse Practitioner
  • Las Cruces, NM
National Provider Identifier
1295080471
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP02003 Issued in NM
Practice address
2170 E Lohman Ave Ste a
Las Cruces, NM 88001-8411
Phone
(056) 818-2955
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R37615 NM
Family Nurse Practitioner 363LF0000X CNP02003 NM Primary

Addresses

Primary practice location

2170 E Lohman Ave Ste a
Las Cruces, NM 88001-8411

Mailing address

2170 E Lohman Ave Ste a
Las Cruces, NM 88001-8411
Phone (056) 818-2955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20120821000556 NM Practitioner - Nurse Practitioner 4880841162 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2990 N Main St
Suite 2B
Las Cruces, NM 88001-1195
Phone (575) 644-0480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R37615NMMDRegistered Nurse
CNP02003NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group LLC CurrentSince Oct 1, 2015 Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 31, 2014 Accepting new patients
Clinica Para Todos CurrentSince Jul 13, 2020 Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 31, 2014 Accepting new patients
American Current Care, P.a. Past Accepting new patients

Locations

4201 Central Ave NW
Ste K3
Albuquerque, NM 87105
Phone (505) 369-1239

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2990 N Main St
Ste 2B
Las Cruces, NM 88001
Phone (505) 526-0888

2170 E Lohman Ave
Ste A
Las Cruces, NM 88001
Phone (575) 524-8888

Interoperability endpoints

  • Direct secure messaging: dolores.cordova@3655.securemail.prognocis.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1295080471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 E LOHMAN AVE STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880018411",
            "telephone_number": "056-818-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 E LOHMAN AVE STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880018411",
            "telephone_number": "056-818-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "DOLORES",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R37615",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP02003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.