Individual provider Active NPI

Lydia Alvarez, FNP

  • Family Nurse Practitioner
  • Salem, OR
National Provider Identifier
1407833239
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP01397 Issued in NM
Practice address
3750 Chemawa Rd NE
Salem, OR 97305-1119
Phone
(503) 304-7600
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP 2038 AZ
Family Nurse Practitioner 363LF0000X NP6044 CA
Family Nurse Practitioner 363LF0000X CNP01397 NM Primary

Addresses

Primary practice location

3750 Chemawa Rd NE
Salem, OR 97305-1119

Mailing address

3750 Chemawa Rd NE
Salem, OR 97305-1119
Phone (503) 304-7600

Other identifiers 2

IdentifierTypeStateIssuer
856825MedicaidAZ
H3451MedicaidNM

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP 2038AZMDFamily Nurse Practitioner
NP6044CAMDFamily Nurse Practitioner
CNP01397NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thoreau Clinic CurrentSince Mar 27, 2014 Accepting new patients
DHHS PHS Naihs Crownpoint Hospital CurrentSince Mar 27, 2014 Accepting new patients
Pueblo Pintado Clinic Current Accepting new patients
Santa Ana Health Center CurrentSince Oct 13, 2019 Accepting new patients
Albuquerque Indian Health Center CurrentSince Oct 13, 2019 Accepting new patients
Chemawa Indian Health Center DHHS IHS Western Oregon Serv Unit CurrentSince Jun 20, 2016 Accepting new patients
DHHS IHS Phoenix Area Past Accepting new patients

Locations

801 Vassar Dr NE
Albuquerque, NM 87106
Phone (505) 248-4000

2 Dove Rd
#C
Bernalillo, NM 87004
Phone (505) 867-2497

3750 Chemawa Rd NE
Salem, OR 97305
Phone (503) 304-7600

Organizations & group practices 7

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1407833239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051119",
            "telephone_number": "503-304-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051119",
            "telephone_number": "503-304-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "LYDIA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP 2038",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP6044",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP01397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856825",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H3451",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.