Gwendolyn Terrazas, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP11567 Issued in AZ

Practice address

1896 E Babbitt LN
San Luis, AZ 85349

Phone

(928) 722-6112

Fax

(928) 722-6113

NPI assigned

Aug 8, 2018

Last updated

Aug 13, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Luis Walk-in Clinic IncGroup PAC ID 2668361841, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

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

• San Luis Walk-in Clinic, Inc.

  • Rural Health Clinic/Center
  • San Luis, AZ
  • NPI 1104228337
  Medicare reassignment Care Compare group NPD
• Regional Center for Border Health, Inc

  dba Family Behavioral Integrated Services

  • Multi-Specialty Clinic/Center
  • Somerton, AZ
  • NPI 1063898260
  Medicare reassignment NPD
• San Luis Walk-in Clinic, Inc.

  dba Lake Havasu Pediatric Family Clinic

  • Rural Health Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1154051753
  NPD
• San Luis Walk-in Clinic, Inc.

  • Rural Health Clinic/Center
  • Somerton, AZ
  • NPI 1003991506
  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1801375126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853500617",
            "telephone_number": "928-662-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 E BABBITT LN",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "85349",
            "telephone_number": "928-722-6112",
            "fax_number": "928-722-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRAZAS",
        "first_name": "GWENDOLYN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP11567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunset Community Health Center
• Sunset Community Health Center
• Sunset Community Health Center Inc
• Sunset Community Health Center Inc (Sunset San Luis Pharmacy)
• Anakany Tavizon Beltran, SA-C
• The Excel Group
• Taliah Anabell Torres, FNP-BC
• Rosenda Uribe
• Evelyn Valenzuela
• Rodolfo Valenzuela IV, NP

• Nurse Practitioner in San Luis, AZ
• Providers in San Luis, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.