Individual provider Active NPI

Mary Ann NMN Spencer, CNP

  • Family Health Clinical Nurse Specialist
  • Las Vegas, NM
National Provider Identifier
1669613568
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
CNP-03110 Issued in NM
Practice address
1235 8TH St
Las Vegas, NM 87701-4219
Phone
(505) 425-6788
Fax
(505) 747-7396
NPI assigned
Mar 23, 2009
Last updated
Nov 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 464128 TX
Family Health Clinical Nurse Specialist 364SF0001X AP126564 TX
Family Health Clinical Nurse Specialist 364SF0001X CNP-03110 NM Primary

Addresses

Primary practice location

1235 8TH St
Las Vegas, NM 87701-4219

Mailing address

PO Box 158
Espanola, NM 87532-0158
Phone (505) 753-7218

Other names 1

  • Ms. Mary Ann NMN Laney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
464128TXMDAmbulatory Care Registered Nurse
AP126564TXMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
El Centro Family Health CurrentSince Nov 28, 2016 Accepting new patients
El Centro Family Health Past Accepting new patients

Locations

1235 8th St
Las Vegas, NM 87701
Phone (505) 425-6751

Organizations & group practices 2

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": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1669613568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875320158",
            "telephone_number": "505-753-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 8TH ST",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014219",
            "telephone_number": "505-425-6788",
            "fax_number": "505-747-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "MARY ANN",
        "middle_name": "NMN",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "TX",
            "license": "464128",
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "TX",
            "license": "AP126564",
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "NM",
            "license": "CNP-03110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANN",
            "last_name": "LANEY",
            "middle_name": "NMN",
            "prefix": "MS.",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NM

Sources for this page

Verify at the official NPI Registry.