Individual provider Active NPI

Nelson Kap-Kirwok

  • Licensed Practical Nurse
  • Las Cruces, NM
National Provider Identifier
1922492941
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP051537 Issued in AZ
Practice address
735 S Mesquite St
Las Cruces, NM 88001-3622
Phone
(616) 566-3803
NPI assigned
Mar 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703114231 MI
Licensed Practical Nurse 164W00000X LP051537 AZ Primary

Addresses

Primary practice location

735 S Mesquite St
Las Cruces, NM 88001-3622

Mailing address

735 S Mesquite St
Las Cruces, NM 88001-3622

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
LP051537AZMDLicensed Practical Nurse
4703114231MIMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Safari Healthcare Associate Current Accepting new patients
Safari Healthcare Foundation CurrentSince Mar 11, 2025 Accepting new patients
New Mexico Support Network Inc CurrentSince Mar 11, 2025 Accepting new patients
Texas Support Network Inc Current Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1922492941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 S MESQUITE ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 S MESQUITE ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013622",
            "telephone_number": "616-566-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAP-KIRWOK",
        "first_name": "NELSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703114231",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP051537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.