Individual provider Active NPI

Gina Vela, CNP

  • Family Nurse Practitioner
  • Roswell, NM
National Provider Identifier
1689158586
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53920 Issued in NM
Practice address
1107 N Main St
Roswell, NM 88201-5009
Phone
(575) 622-5705
Fax
(575) 622-5708
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53920 NM Primary

Addresses

Primary practice location

1107 N Main St
Roswell, NM 88201-5009

Mailing address

1107 N Main St
Roswell, NM 88201-5009
Phone (575) 622-5705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009002329 NM Practitioner - Nurse Practitioner 2365794930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1107 N Main St
Roswell, NM 88201-5009

Hospital & facility affiliations

  • Lovelace Regional Hospital - Roswell Hospital, Roswell, NM, CCN 320086
  • Eastern New Mexico Medical Center Hospital, Roswell, NM, CCN 320006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53920NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Family Care, LLC Family CurrentSince Sep 1, 2018 Accepting new patients

Locations

1107 N Main St
Roswell, NM 88201
Phone (575) 622-5705

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1689158586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015009",
            "telephone_number": "575-622-5705",
            "fax_number": "575-622-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015009",
            "telephone_number": "575-622-5705",
            "fax_number": "575-622-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELA",
        "first_name": "GINA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "53920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.