Individual provider Active NPI

Cheryll L Willin, CNP

  • Nurse Practitioner
  • Santa Fe, NM
National Provider Identifier
1508916875
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP-01513 Issued in NM
Practice address
490A W Zia Rd
Santa Fe, NM 87505-6996
Phone
(505) 913-8900
Fax
(505) 913-6441
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 13235 CA
Nurse Practitioner 363L00000X CNP-01513 NM Primary

Addresses

Primary practice location

490A W Zia Rd
Santa Fe, NM 87505-6996

Mailing address

490A W Zia Rd
New Mexico Cancer Care Associates
Santa Fe, NM 87505-6996
Phone (505) 913-8900

Other identifiers 1

IdentifierTypeStateIssuer
62820532MedicaidNM

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
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13235CAMDEmergency Medicine Physician
CNP-01513NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Oncology Hematology Consultants, LTD. Past Accepting new patients

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1508916875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490A W ZIA RD",
            "address_2": "NEW MEXICO CANCER CARE ASSOCIATES",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056996",
            "telephone_number": "505-913-8900",
            "fax_number": "505-913-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490A W ZIA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056996",
            "telephone_number": "505-913-8900",
            "fax_number": "505-913-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIN",
        "first_name": "CHERYLL",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "13235",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-01513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62820532",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; 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.