Individual provider Active NPI

Jennifer Deroy, CNP

  • Nurse Practitioner
  • Alamogordo, NM
National Provider Identifier
1609843689
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP00916 Issued in NM
Practice address
2150 Highway 54 S
Alamogordo, NM 88310-7330
Phone
(575) 443-8133
Fax
(575) 443-8055
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R41076 NM
Nurse Practitioner 363L00000X CNP00916 NM Primary

Addresses

Primary practice location

2150 Highway 54 S
Alamogordo, NM 88310-7330

Mailing address

PO Box 370
Hatch, NM 87937-0370
Phone (575) 267-3280

Other identifiers 1

IdentifierTypeStateIssuer
49626248MedicaidNM

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
I20060104000333 NM Practitioner - Nurse Practitioner 0547280422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cura HealthcareGroup PAC ID 5799143103, 81 clinicians
Otero County Hospital AssociationGroup PAC ID 3173516606, 245 clinicians

Practice addresses (Care Compare)

Albuquerque, NM 87110
Phone (505) 413-3719

2669 Scenic Dr
Alamogordo, NM 88310-8700
Phone (505) 439-6100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R41076NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Otero County Hospital Association CurrentSince Mar 10, 2025 Accepting new patients
Otero County Hospital Association CurrentSince Mar 10, 2025 Accepting new patients
Cura Healthcare Family CurrentSince Oct 17, 2024 Accepting new patients

Locations

1501 10th St
Alamogordo, NM 88310
Phone (505) 443-8133

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

8226 Menaul Blvd NE
Albuquerque, NM 87110
Phone (505) 413-3719

7683 SE 27th St
Mercer Island, WA 98040
Phone (206) 228-8530

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1609843689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 HIGHWAY 54 S",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883107330",
            "telephone_number": "575-443-8133",
            "fax_number": "575-443-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROY",
        "first_name": "JENNIFER",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R41076",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP00916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49626248",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamogordo, NM

Sources for this page

Verify at the official NPI Registry.