Individual provider Active NPI

Jaclyn Vasquez

  • School Registered Nurse
  • Anthony, NM
National Provider Identifier
1336882091
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN-69224 Issued in NM
Practice address
1451 Donaldson Ave
Anthony, NM 88021-8802
Phone
(575) 882-6101
NPI assigned
Apr 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN-69224 NM Primary

Addresses

Primary practice location

1451 Donaldson Ave
Anthony, NM 88021-8802

Mailing address

PO Drawer 70
Anthony, NM 88021
Phone (575) 882-6101

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

State licenses

LicenseStateTypeSpecialty
RN-69224NMMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gadsden Independent School District PastSince Apr 24, 2022 Accepting new patients
Gadsden Independent School District PastSince Apr 24, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1336882091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 70",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "88021",
            "telephone_number": "575-882-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 DONALDSON AVE",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "880218802",
            "telephone_number": "575-882-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JACLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NM",
            "license": "RN-69224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anthony, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.