Individual provider Active NPI

Laci Ohare

  • Family Nurse Practitioner
  • Clovis, NM
National Provider Identifier
1841861697
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
64070 Issued in NM
Practice address
2301 N. M.L.K. Blvd
Clovis, NM 88101-8810
Phone
(575) 762-4455
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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 64070 NM Primary

Addresses

Primary practice location

2301 N. M.L.K. Blvd
Clovis, NM 88101-8810

Mailing address

2301 N. Martin Luther King Jr. Blvd
Clovis, NM 88101
Phone (757) 762-4455

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
I20210714002421 NM Practitioner - Nurse Practitioner 4880096734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clovis Family Urgent Care LLCGroup PAC ID 4284095324, 9 clinicians
Clovis Family Health Care Center LLCGroup PAC ID 6002720455, 4 clinicians

Practice addresses (Care Compare)

2301 N Dr Martin Luther King Jr Blvd
Clovis, NM 88101-9401
Phone (575) 762-4455

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64070NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clovis Family Health Care Center LLC CurrentSince Jun 7, 2021 Accepting new patients
Clovis Family Urgent Care LLC CurrentSince Jul 1, 2023 Accepting new patients
Clovis Family Health Care Center LLC PastSince Jun 21, 2022 Accepting new patients

Locations

2301 N Mlk Blvd
Clovis, NM 88101
Phone (575) 762-4455

Interoperability endpoints

  • Direct secure messaging: laci.ohare@762372768137220.direct.elationemr.com

Organizations & group practices 3

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": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1841861697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N. MARTIN LUTHER KING JR. BLVD",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "88101",
            "telephone_number": "757-762-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N. M.L.K. BLVD",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881018810",
            "telephone_number": "575-762-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHARE",
        "first_name": "LACI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "64070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.