Active NPI
Monica Gutierrez, CHW
- Community Health Worker
- Grants Pass, OR
National Provider Identifier
1659087070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 108206
- Practice address
- 2101 Cullison LN
Grants Pass, OR 97527-5735 - Phone
- (541) 622-1433
- NPI assigned
- Jan 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 108206 | OR | Primary |
Addresses
Primary practice location
2101 Cullison LN
Grants Pass, OR 97527-5735
Mailing address
2101 Cullison LN
Grants Pass, OR 97527-5735
Phone (541) 622-1433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5520691 | Other | OR | OREGON DRIVERS LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 108206 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675036800000",
"number": "1659087070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 CULLISON LN",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275735",
"telephone_number": "541-622-1433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 CULLISON LN",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275735",
"telephone_number": "541-622-1433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "MONICA",
"name_prefix": "Miss",
"credential": "CHW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-30",
"last_updated": "2023-01-30",
"certification_date": "2023-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "108206",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON DRIVERS LICENSE",
"identifier": "5520691",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.