Individual provider Active NPI

Carlos Ivan Quintana, LVN

  • Licensed Vocational Nurse
  • El Paso, TX
National Provider Identifier
1679112114
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
342775 Issued in TX
Practice address
12949 Eastbrook Dr Apt 353
El Paso, TX 79938-5537
Phone
(714) 269-5241
NPI assigned
Jan 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 342775 TX Primary

Addresses

Primary practice location

12949 Eastbrook Dr Apt 353
El Paso, TX 79938-5537

Mailing address

12949 Eastbrook Dr Apt 353
El Paso, TX 79938-5537
Phone (714) 269-5241

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
342775TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1679112114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12949 EASTBROOK DR APT 353",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799385537",
            "telephone_number": "714-269-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12949 EASTBROOK DR APT 353",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799385537",
            "telephone_number": "714-269-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA",
        "first_name": "CARLOS",
        "middle_name": "IVAN",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "342775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.