FLT LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP-02765 Issued in NM

Legal business name

FLT LLC

Doing business as

Ocotillo Family Practice

Practice address

313 W Country Club Rd Ste 15
Roswell, NM 88201-5804

Phone

(575) 914-0055

NPI assigned

Sep 14, 2015

Last updated

Sep 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawn Wulf, CNPNPI 1174992671

Title

Owner

Phone

(575) 914-0055

Specialties & licenses 1

Addresses

Other names 1

• OCOTILLO FAMILY PRACTICE Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dawn Wulf

  • Family Nurse Practitioner
  • Roswell, NM
  • NPI 1174992671
  Medicare reassignment Authorized official
• Andrea Vega, NP

  • Family Nurse Practitioner
  • Roswell, NM
  • NPI 1316625361
  Medicare reassignment
• Nancy Walker, FNP-C

  • Primary Care Nurse Practitioner
  • Ruidoso, NM
  • NPI 1467223420
  Medicare reassignment
• Thomas W Wulf, M.D.

  • Family Medicine Physician
  • Roswell, NM
  • NPI 1467405779
  Medicare reassignment

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1366810970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 W COUNTRY CLUB RD STE 15",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W COUNTRY CLUB RD STE 15",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015804",
            "telephone_number": "575-914-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "WULF",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-914-0055",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-02765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OCOTILLO FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leslie Fitzwater, LCSW
• Drake Flanigan
• Evanli Flores
• Shelby Flores, SLP CLINICAL FELLOW
• Anna Florez, FNP
• Carrie Flury, PA-C
• Yasmin Fody
• Mandy Ford
• Foundation Counseling Services LLC
• Founders Healthcare LLC

• Family Nurse Practitioner in Roswell, NM
• Providers in Roswell, 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 Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.