Individual provider Active NPI

Jennifer Mayorga

  • Registered Nurse
  • El Paso, TX
National Provider Identifier
1700460474
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
960944 Issued in TX
Practice address
444 Executive Center Blvd Ste 148
El Paso, TX 79902-1096
Phone
(915) 213-1289
NPI assigned
May 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 960944 TX Primary

Addresses

Primary practice location

444 Executive Center Blvd Ste 148
El Paso, TX 79902-1096

Mailing address

444 Executive Center Blvd Ste 148
El Paso, TX 79902-1096
Phone (915) 213-1289

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
960944TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1700460474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 EXECUTIVE CENTER BLVD STE 148",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021096",
            "telephone_number": "915-213-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 EXECUTIVE CENTER BLVD STE 148",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021096",
            "telephone_number": "915-213-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYORGA",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "960944",
            "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 May 10, 2021; 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.