Elizabeth Ann Portugal, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

563927 Issued in TX

Practice address

9870 Gateway N Blvd B1
El Paso, TX 79924-4414

Phone

(915) 751-5571

Fax

(915) 751-0951

NPI assigned

Sep 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1699879981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9870 GATEWAY N BLVD B1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244414",
            "telephone_number": "915-751-5571",
            "fax_number": "915-751-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9870 GATEWAY N BLVD B1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244414",
            "telephone_number": "915-751-5571",
            "fax_number": "915-751-0951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9870 GATEWAY N BLVD B1",
            "address_purpose": "LOCATION",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244414",
            "country_code": "US",
            "telephone_number": "915-751-5571",
            "fax_number": "915-751-0951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTUGAL",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "563927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176130601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8N8628",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Advanced Practice Midwife in El Paso, TX
• Providers in El Paso, TX by specialty
• Advanced Practice Midwife in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.