Individual provider Active NPI

Jennifer L Carrasco, CLC , CD

  • Doula
  • Alamogordo, NM
National Provider Identifier
1679002448
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
1341 Columbia Ave
Alamogordo, NM 88310-8012
Phone
(575) 404-1717
Fax
(575) 404-1717
NPI assigned
Jun 6, 2017
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X ALPP-258224 MA
Doula 374J00000X NM Primary

Addresses

Primary practice location

1341 Columbia Ave
Alamogordo, NM 88310-8012

Mailing address

1341 Columbia Ave
Alamogordo, NM 88310-8012
Phone (575) 404-1717

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
ALPP-258224MAMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1679002448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 COLUMBIA AVE",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108012",
            "telephone_number": "575-404-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 COLUMBIA AVE",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108012",
            "telephone_number": "575-404-1717",
            "fax_number": "575-404-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASCO",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "CLC , CD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "MA",
            "license": "ALPP-258224",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamogordo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.