Clarisse Vanessa Ngueha-Nana

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP8915 Issued in AZ

Practice address

1233 N Main St Ste 10
San Luis, AZ 85336-0663

Phone

(928) 722-6098

Fax

(928) 627-0007

NPI assigned

Jul 27, 2016

Last updated

Oct 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/EHDHCA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• San Jose Integrated Clinic LLC

  • Family Nurse Practitioner
  • San Luis, AZ
  • NPI 1386287753
  Medicare reassignment NPD Authorized official
• Altea Medical Clinic PLLC

  • Health Maintenance Organization
  • Yuma, AZ
  • NPI 1669883864
  Medicare reassignment NPD
• Ashvin K. Shah, M.D., PC

  • Sleep Medicine (Internal Medicine) Physician
  • Yuma, AZ
  • NPI 1992915284
  Medicare reassignment NPD
• Corner Health Medical Group P a

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1205689171
  Medicare reassignment NPD
• Horizon Health and Wellness, Inc.

  • General Practice Physician
  • Apache Junction, AZ
  • NPI 1659308989
  Medicare reassignment NPD
• Horizon Health and Wellness, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Casa Grande, AZ
  • NPI 1164451381
  NPD
• Horizon Health and Wellness, Inc.

  • Federally Qualified Health Center (FQHC)
  • Globe, AZ
  • NPI 1689436412
  NPD
• San Luis Walk-in Clinic, Inc.

  • Rural Health Clinic/Center
  • Somerton, AZ
  • NPI 1003991506
  NPD (past)
• San Luis Walk-in Clinic, Inc.

  dba San Luis Urgent Care

  • Urgent Care Clinic/Center
  • San Luis, AZ
  • NPI 1144680455
  NPD (past)

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1356894240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1689",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853491689",
            "telephone_number": "928-722-6098",
            "fax_number": "928-627-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 N MAIN ST STE 10",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853360663",
            "telephone_number": "928-722-6098",
            "fax_number": "928-627-0007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1394 W 16th St Ste B-3",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853644430",
            "country_code": "US",
            "telephone_number": "928-328-8011",
            "fax_number": "928-327-1270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUEHA-NANA",
        "first_name": "CLARISSE",
        "middle_name": "VANESSA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130813",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163137",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Montufar, CNM
• Rosario Alejandra Morales Villegas, SLPA
• Agustin Morales, M.D.
• Larry Anthony Morales, FNP-C
• Siyanda Obed Mquqwana, OT
• Armik Ohanesyan Salmas
• Alejandro Olea
• Maricela Sevilla Olea, FNP-C
• Angeles Olivarez
• Melissa Ortega

• Family Nurse Practitioner in San Luis, AZ
• Providers in San Luis, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.