Individual provider Active NPI

Alyssa Lightbourn

  • School Registered Nurse
  • Sunland Park, NM
National Provider Identifier
1477900447
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
788941 Issued in TX
Practice address
305 Alto Vista Dr
Sunland Park, NM 88063-9116
Phone
(575) 589-1114
NPI assigned
May 19, 2016
Last updated
May 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 788941 TX Primary

Addresses

Primary practice location

305 Alto Vista Dr
Sunland Park, NM 88063-9116

Mailing address

PO Box 70
Anthony, NM 88021-0070

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

LicenseStateTypeSpecialty
788941TXMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gadsden Independent School District Past Accepting new patients
Gadsden Independent School District Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1477900447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "880210070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ALTO VISTA DR",
            "city": "SUNLAND PARK",
            "state": "NM",
            "postal_code": "880639116",
            "telephone_number": "575-589-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTBOURN",
        "first_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "TX",
            "license": "788941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunland Park, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.