Active NPI
Mary A Gomez, FNP
- Family Nurse Practitioner
- Madera, CA
National Provider Identifier
1811973845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10694
- Practice address
- 124 S a St
Madera, CA 93638-3619 - Phone
- (559) 664-4000
- NPI assigned
- Dec 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10694 | CA | Primary |
Addresses
Primary practice location
124 S a St
Madera, CA 93638-3619
Mailing address
PO Box 299
Madera, CA 93639-0299
Phone (559) 664-4000
Other practice location 1
344 E 6th St
Madera, CA 93638-3631
Phone (559) 664-4000
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10694 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550707200000",
"number": "1811973845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 299",
"city": "MADERA",
"state": "CA",
"postal_code": "936390299",
"telephone_number": "559-664-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 S A ST",
"city": "MADERA",
"state": "CA",
"postal_code": "936383619",
"telephone_number": "559-664-4000"
}
],
"practiceLocations": [
{
"address_1": "344 E 6th St",
"address_purpose": "LOCATION",
"city": "Madera",
"state": "CA",
"postal_code": "936383631",
"country_code": "US",
"telephone_number": "559-664-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOMEZ",
"first_name": "MARY",
"middle_name": "A",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-21",
"last_updated": "2019-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "10694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.