Individual provider Active NPI

Nicole Chavez Lucero, COTA

  • Occupational Therapy Assistant
  • Las Cruces, NM
National Provider Identifier
1609383090
Registry record updated Jan 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3684 Issued in NM
Practice address
1350 Hillrise Cir
Las Cruces, NM 88011-4759
Phone
(575) 522-9500
NPI assigned
Jan 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3684 NM Primary

Addresses

Primary practice location

1350 Hillrise Cir
Las Cruces, NM 88011-4759

Mailing address

4688 Rimrock Dr
Las Cruces, NM 88012-5061
Phone (575) 621-0545

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
3684NMMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1515283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515283200000",
    "number": "1609383090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4688 RIMROCK DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880125061",
            "telephone_number": "575-621-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HILLRISE CIR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114759",
            "telephone_number": "575-522-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "NICOLE",
        "middle_name": "CHAVEZ",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-07",
        "last_updated": "2018-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "3684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2018; 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.