Andrea Diane Carrillo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

54911 Issued in NM

Practice address

2402 W Pierce St Ste 6a
Carlsbad, NM 88220-3566

Phone

(575) 706-5887

NPI assigned

Feb 1, 2019

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1911/brand/1/csg/1/fhir/r4

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.

• American Medical Group Inc.

  • General Practice Physician
  • Hobbs, NM
  • NPI 1255441051

  Family

  Medicare reassignment NPD
• New Mexico Center for Pain and Wellness, LLC

  • Pain Medicine Physician
  • Albuquerque, NM
  • NPI 1033803143
  Medicare reassignment NPD
• Post Acute Rehabilitation Physicians LLC

  • Physical Medicine & Rehabilitation Physician
  • Lehi, UT
  • NPI 1023781028

  NM

  Medicare reassignment NPD
• True Health LLC

  • Sports Medicine (Family Medicine) Physician
  • Carlsbad, NM
  • NPI 1245978030
  NPD (past) Authorized official
• Colorado Center for Pain and Wellness, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Colorado Springs, CO
  • NPI 1033918131
  NPD
• Briarwood Clinic, LLC

  • Family Nurse Practitioner
  • Midland, TX
  • NPI 1881069995
  NPD (past)

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1306301551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 N FOWLER ST",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882402312",
            "telephone_number": "575-392-2040",
            "fax_number": "575-392-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 W PIERCE ST STE 6A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203566",
            "telephone_number": "575-706-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "ANDREA",
        "middle_name": "DIANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "54911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlsbad Spine Pain Sports Medicine PC
• Justine Brittany Carmichael, MSN, FNP-C
• Alison Caron
• Devonica Carrasco, LMSW
• Lena Jean Carrasco, CNS
• Earl C Cason
• Cristina Castro, DVM
• Delia Rachelle Cathey, CNP
• Indie Cervantes
• Makayla Chain, PT, DPT

• Family Nurse Practitioner in Carlsbad, NM
• Providers in Carlsbad, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.