Individual provider Active NPI

Jayanna Warwick, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1437407301
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP02033 Issued in NM
Practice address
2015 Wyoming Blvd NE
Suite F
Albuquerque, NM 87112-2622
Phone
(505) 967-4773
Fax
(505) 967-4398
NPI assigned
Aug 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP02033 NM Primary

Addresses

Primary practice location

2015 Wyoming Blvd NE
Suite F
Albuquerque, NM 87112-2622

Mailing address

2015 Wyoming Blvd NE
Suite F
Albuquerque, NM 87112-2622
Phone (505) 967-4773

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120926000551 NM Practitioner - Nurse Practitioner 0143479626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elemental Health and Wellness Center LLCGroup PAC ID 0446481881, 12 clinicians

Practice addresses (Care Compare)

4425 Juan Tabo Blvd NE
Suite 112
Albuquerque, NM 87111-2684
Phone (505) 503-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP02033NMMDPsychiatric/Mental Health Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1345939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1437407301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 WYOMING BLVD NE",
            "address_2": "SUITE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122622",
            "telephone_number": "505-967-4773",
            "fax_number": "505-967-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 WYOMING BLVD NE",
            "address_2": "SUITE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122622",
            "telephone_number": "505-967-4773",
            "fax_number": "505-967-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARWICK",
        "first_name": "JAYANNA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-26",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP02033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.