Active NPI
Virginia Becenti Yazzie, CMS
- Case Manager/Care Coordinator
- Gallup, NM
National Provider Identifier
1407067135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 11-119
- Practice address
- 300 W Nizhoni Blvd Ste a
Gallup, NM 87301-5766 - Phone
- (505) 722-9470
- Fax
- (505) 722-9570
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 11-119 | AZ | Primary |
Addresses
Primary practice location
300 W Nizhoni Blvd Ste a
Gallup, NM 87301-5766
Mailing address
300 W Nizhoni Blvd Ste a
Gallup, NM 87301-5766
Phone (505) 722-9470
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11-119 | AZ | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gallup Outpatient Treatment Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Gallup, NM
- NPI 1588925788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646265600000",
"number": "1407067135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W NIZHONI BLVD STE A",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015766",
"telephone_number": "505-722-9470",
"fax_number": "505-722-9570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W NIZHONI BLVD STE A",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015766",
"telephone_number": "505-722-9470",
"fax_number": "505-722-9570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAZZIE",
"first_name": "VIRGINIA",
"middle_name": "BECENTI",
"name_prefix": "Ms.",
"credential": "CMS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2022-03-03",
"certification_date": "2022-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "AZ",
"license": "11-119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.