Vivian B Gallegos, R.N.

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

RN-59707 Issued in CO

Practice address

233 Main Street
Suite C
San Luis, CO 81152

Phone

(719) 672-3332

Fax

(719) 672-3856

NPI assigned

May 3, 2012

Last updated

May 3, 2012By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• County of Costilla

  dba Costilla County Public Health Agency

  • Public Health or Welfare Agency
  • San Luis, CO
  • NPI 1972725455
  NPD (past) Authorized official
• County of Costilla

  • Public Health or Welfare Agency
  • San Luis, CO
  • NPI 1427722669
  NPD (past)

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1427317999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "SAN LUIS",
            "state": "CO",
            "postal_code": "811520099",
            "telephone_number": "719-672-3332",
            "fax_number": "719-672-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 MAIN STREET",
            "address_2": "SUITE C",
            "city": "SAN LUIS",
            "state": "CO",
            "postal_code": "81152",
            "telephone_number": "719-672-3332",
            "fax_number": "719-672-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "VIVIAN",
        "middle_name": "B",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CO",
            "license": "RN-59707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costilla County Ambulance District
• Costilla County Ambulance District
• County of Costilla
• County of Costilla (Costilla County Public Health Agency)
• Donna Ruth Descoteaux, LCSW
• Anatniuq Gonzales, RN
• Emelin Martinez, FNP
• Maryanne Martinez, R.N.
• Carrie Ann Mondragon, RN
• Joseph Quintana, MD

• Administrator Registered Nurse in San Luis, CO
• Providers in San Luis, CO by specialty
• Administrator Registered Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.