Fos Wellness, LTD

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

FOS WELLNESS, LTD

Practice address

1698 S Roosevelt Road 13
Portales, NM 88130-8705

Phone

(575) 607-8702

Fax

(800) 421-8110

NPI assigned

Aug 27, 2018

Organization subpart

Yes

Parent organization

FOS WELLNESS, LTDAs reported in NPPES

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

Authorized official

Name

Mrs. Rebecca Kizer, MSN, FNP-BC, CFNCNPI 1699154245

Title

President

Phone

(575) 607-8702

Specialties & licenses 5

Addresses

Other names 1

• Trinity Christian Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Fos Wellness LTD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Kathleen Kizer, APRN, FNP-BC, CFNC

  • Family Nurse Practitioner
  • Lubbock, TX
  • NPI 1699154245

  Nutrition Support

  NPD Authorized official

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1982185948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 S ROOSEVELT ROAD 13",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881308705",
            "telephone_number": "575-607-8702",
            "fax_number": "800-421-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 S ROOSEVELT ROAD 13",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881308705",
            "telephone_number": "575-607-8702",
            "fax_number": "800-421-8110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1812 S Roosevelt Road 8",
            "address_purpose": "LOCATION",
            "city": "Portales",
            "state": "NM",
            "postal_code": "881309724",
            "country_code": "US",
            "telephone_number": "575-607-8702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOS WELLNESS, LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOS WELLNESS, LTD",
        "enumeration_date": "2018-08-27",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "KIZER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "575-607-8702",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN, FNP-BC, CFNC"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-72322",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NM",
            "license": "RN-72322",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "NM",
            "license": "RN-72322",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Christian Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trinity Christian Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Portales, NM
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.