Individual provider Active NPI

Brijido R Olivarez Jr.

  • School Registered Nurse
  • Alamogordo, NM
National Provider Identifier
1992413090
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
R56504 Issued in NM
Practice address
1900 N White Sands Blvd
Alamogordo, NM 88310-6246
Phone
(575) 439-4457
Fax
(575) 439-4494
NPI assigned
Nov 8, 2022
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X R56504 NM Primary

Addresses

Primary practice location

1900 N White Sands Blvd
Alamogordo, NM 88310-6246

Mailing address

1900 N White Sands Blvd
Alamogordo, NM 88310-6246
Phone (575) 439-4457

Other practice location 1

1900 N White Sands Blvd
Alamogordo, NM 88310-6246
Phone (575) 439-4457

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
R56504NMMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico School for the Blind and Visually Impaired Early Childhood PastSince Nov 13, 2022 Accepting new patients
New Mexico School for the Blind and Visually Impaired PastSince Nov 13, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1992413090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 N WHITE SANDS BLVD",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883106246",
            "telephone_number": "575-439-4457",
            "fax_number": "575-439-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N WHITE SANDS BLVD",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883106246",
            "telephone_number": "575-439-4457",
            "fax_number": "575-439-4494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 N White Sands Blvd",
            "address_purpose": "LOCATION",
            "city": "Alamogordo",
            "state": "NM",
            "postal_code": "883106246",
            "country_code": "US",
            "telephone_number": "575-439-4457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVAREZ",
        "first_name": "BRIJIDO",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NM",
            "license": "R56504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamogordo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.