Individual provider Active NPI

Quillian Young-Lewis, CNP

  • Family Nurse Practitioner
  • Alamogordo, NM
National Provider Identifier
1679039465
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-67508 Issued in NM
Practice address
2050 Scenic Dr
Alamogordo, NM 88310-3880
Phone
(575) 434-0901
Fax
(833) 918-0925
NPI assigned
Feb 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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 2019000935 MO
Family Nurse Practitioner 363LF0000X CNP-67508 NM Primary

Addresses

Primary practice location

2050 Scenic Dr
Alamogordo, NM 88310-3880

Mailing address

2050 Scenic Dr
Alamogordo, NM 88310-3880
Phone (575) 434-0901

Other practice location 1

525 N Keene St Ste 301
Columbia, MO 65201-8106
Phone (573) 449-2141

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2019000935MOMDFamily Nurse Practitioner
CNP-67508NMMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1550275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1679039465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 SCENIC DR",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883103880",
            "telephone_number": "575-434-0901",
            "fax_number": "833-918-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 SCENIC DR",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883103880",
            "telephone_number": "575-434-0901",
            "fax_number": "833-918-0925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 N Keene St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652018106",
            "country_code": "US",
            "telephone_number": "573-449-2141",
            "fax_number": "573-875-2328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG-LEWIS",
        "first_name": "QUILLIAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-16",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019000935",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-67508",
            "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 Apr 7, 2022; 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.