Individual provider Active NPI

Stacey Chavez, FNP

  • Family Nurse Practitioner
  • Clovis, NM
National Provider Identifier
1871146464
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
57003 Issued in NM
Practice address
105 Redwing
Clovis, NM 88101-9597
Phone
(575) 309-7237
NPI assigned
Jul 22, 2019
Last updated
Jul 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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 57003 NM Primary

Addresses

Primary practice location

105 Redwing
Clovis, NM 88101-9597

Mailing address

105 Redwing
Clovis, NM 88101-9597
Phone (575) 309-7237

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
I20191115000288 NM Practitioner - Nurse Practitioner 6406288349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

2421 W 21St St
Clovis, NM 88101-2006
Phone (575) 769-7577

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57003NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Oct 4, 2019 Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 4, 2019 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2421 W 21st St
Ste B
Clovis, NM 88101
Phone (575) 742-7824

Interoperability endpoints

  • Direct secure messaging: schavez152184@direct.phs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1871146464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 REDWING",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019597",
            "telephone_number": "575-309-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 REDWING",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019597",
            "telephone_number": "575-309-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "STACEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "57003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.