Active NPI
Jeremy James Baldillez
- School Psychologist
- Las Cruces, NM
National Provider Identifier
1003004359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 275299
- Practice address
- 3100 Oak St
Las Cruces, NM 88005-3425 - Phone
- (575) 323-3354
- Fax
- (575) 523-3354
- NPI assigned
- Oct 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 275299 | NM | Primary |
Addresses
Primary practice location
3100 Oak St
Las Cruces, NM 88005-3425
Mailing address
505 S Main St
Ste 249
Las Cruces, NM 88001-1206
Phone (505) 527-5823
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
| License | State | Type | Specialty |
|---|---|---|---|
| 275299 | NM | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Las Cruces School District No. 2 | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Las Cruces, NM
- NPI 1851301857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492732800000",
"number": "1003004359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S MAIN ST",
"address_2": "STE 249",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880011206",
"telephone_number": "505-527-5823",
"fax_number": "505-527-5886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 OAK ST",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053425",
"telephone_number": "575-323-3354",
"fax_number": "575-523-3354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDILLEZ",
"first_name": "JEREMY",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-11",
"last_updated": "2017-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NM",
"license": "275299",
"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 Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.