Active NPI
Brandi Gorzeman, R.N.
- Nurse Practitioner
- Las Cruces, NM
National Provider Identifier
1962823914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 74019
- Practice address
- 530 N Telshor Blvd
Las Cruces, NM 88011-8243 - Phone
- (575) 303-2929
- Fax
- (752) 336-2605
- NPI assigned
- Dec 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 74019 | NM | Primary |
| School Registered Nurse | 163WS0200X | R41405 | NM |
Addresses
Primary practice location
530 N Telshor Blvd
Las Cruces, NM 88011-8243
Mailing address
PO Box 2845
Las Cruces, NM 88004-2845
Phone (575) 303-2929
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230815000059 | NM | Practitioner - Nurse Practitioner | 5193194538 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R41405 | NM | MD | School Registered Nurse |
| 74019 | NM | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Primary Care, LLC | Current | Accepting new patients | |
| B-Well, LLC | Current | Accepting new patients |
Locations
2930 Hillrise Dr
Ste 6
Las Cruces, NM 88011
Phone (575) 652-1540
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.
-
- Methadone Clinic
- Las Cruces, NM
- NPI 1568168342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1962823914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2845",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880042845",
"telephone_number": "575-303-2929",
"fax_number": "575-233-6260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 N TELSHOR BLVD",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880118243",
"telephone_number": "575-303-2929",
"fax_number": "752-336-2605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORZEMAN",
"first_name": "BRANDI",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-18",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NM",
"license": "74019",
"primary": true
},
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "NM",
"license": "R41405",
"primary": false
}
],
"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 Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.