Jina Vick, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R14987 Issued in NM

Practice address

303 E Washington Ave
Tucumcari, NM 88401-3873

Phone

(575) 461-4464

NPI assigned

Sep 13, 2005

Last updated

Jul 12, 2010By 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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

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.

• Jina Vick, CNP, PC

  • Nurse Practitioner
  • Tucumcari, NM
  • NPI 1215125950
  NPD (past) Authorized official

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1952396244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E WASHINGTON AVE",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884013873",
            "telephone_number": "575-461-4464",
            "fax_number": "575-461-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E WASHINGTON AVE",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884013873",
            "telephone_number": "575-461-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICK",
        "first_name": "JINA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R14987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN SALUD",
            "identifier": "201022182",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00NM009J49",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000Z6045",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "53794",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00061317",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desaray Dawn Urioste
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• Brandi Nicole Arias Varnado, MPT
• Frank A Velazquez, CRNA
• Hannah Brooke Walker, M.S. CCC-SLP
• Lynette Walker, BMS
• Haily Wallace, MD
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• Becky Whitson

• Family Nurse Practitioner in Tucumcari, NM
• Providers in Tucumcari, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.