Edna Gail Gutierrez, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP00610 Issued in NM

Practice address

121 N. Main
Melrose, NM 88124

Phone

(575) 253-4373

Fax

(575) 253-4575

NPI assigned

Aug 30, 2005

Last updated

Aug 16, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Edna Gail Johnson Former name

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

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/DGGJCD

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.

• De Baca Family Practice Clinic

  • Federally Qualified Health Center (FQHC)
  • Fort Sumner, NM
  • NPI 1003855032
  Medicare reassignment NPD
• Alignmed Partners, PC

  dba GPS Physician Group PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gardendale, AL
  • NPI 1881109452

  NM

  Medicare reassignment NPD
• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment
• De Baca Family Practice Clinic

  dba De Baca Family Practice Clinic/Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Fort Sumner, NM
  • NPI 1114737483
  NPD
• Clovis Family Health Care Center LLC

  • Family Medicine Physician
  • Clovis, NM
  • NPI 1760123475
  NPD (past)
• David a Stalker MD PA

  • Surgery Physician
  • Clovis, NM
  • NPI 1275582470
  NPD (past)
• Lea Emergency Group LLC

  • Emergency Medicine Physician
  • Hobbs, NM
  • NPI 1063521938
  NPD (past)
• Valley Emergency Physicians New Mexico PC

  • Emergency Medicine Physician
  • Clovis, NM
  • NPI 1891005534
  NPD (past)
• Via Christi Medical Clinic, Inc.

  • Family Medicine Physician
  • Clovis, NM
  • NPI 1730131848
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1376536854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881300299",
            "telephone_number": "575-356-6652",
            "fax_number": "575-359-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N. MAIN",
            "city": "MELROSE",
            "state": "NM",
            "postal_code": "88124",
            "telephone_number": "575-253-4373",
            "fax_number": "575-253-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "EDNA",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R30396",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP00610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDNA",
            "last_name": "JOHNSON",
            "middle_name": "GAIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Coddington, RN
• Tammie Jean Jacobs, COTA/L
• Zanessa D. Kastler, LCSW
• La Casa de Buena Salud Inc (La Casa Family Health Center)
• Karla Annette Moore, M.S., CCC-SLP
• Roosevelt County Special Hospital District

• Family Nurse Practitioner in Melrose, NM
• Providers in Melrose, 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 Aug 16, 2016; 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.