Individual provider Active NPI

Silvia Lizveth Degollado, NP-C

  • Family Nurse Practitioner
  • Mission, TX
National Provider Identifier
1497269310
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP135962 Issued in TX
Practice address
1512 E Griffin Pkwy Ste 2
Mission, TX 78572-2422
Phone
(956) 519-7088
NPI assigned
Nov 30, 2017
Last updated
Mar 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135962 TX Primary

Addresses

Primary practice location

1512 E Griffin Pkwy Ste 2
Mission, TX 78572-2422

Mailing address

1512 E Griffin Pkwy Ste 2
Mission, TX 78572-2422
Phone (956) 519-7088

Other practice location 1

1001 James St
Weslaco, TX 78596-0008
Phone (956) 968-7274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180315001809 TX Practitioner - Nurse Practitioner 8729340591 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP135962TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Jul 1, 2018 Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 1, 2018 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Mario R Anzaldua MD PA CurrentSince Dec 15, 2019 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Dec 1, 2019 Accepting new patients
Wellmed Medical Group, PA PastSince Dec 15, 2019 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

1512 E Griffin Pkwy
Ste 2
Mission, TX 78572
Phone (956) 519-7088

Organizations & group practices 6

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": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1497269310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 E GRIFFIN PKWY STE 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785722422",
            "telephone_number": "956-519-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 E GRIFFIN PKWY STE 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785722422",
            "telephone_number": "956-519-7088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 James St",
            "address_purpose": "LOCATION",
            "city": "Weslaco",
            "state": "TX",
            "postal_code": "785960008",
            "country_code": "US",
            "telephone_number": "956-968-7274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGOLLADO",
        "first_name": "SILVIA",
        "middle_name": "LIZVETH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.