Pinon Healthcare, LLC

Primary specialty

Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X

Legal business name

PINON HEALTHCARE, LLC

Practice address

904 E 20TH St Ste B
Farmington, NM 87401-4281

Phone

(505) 787-2680

Fax

(505) 787-2668

NPI assigned

Aug 27, 2019

Organization subpart

No

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

Authorized official

Name

Dikilyn Tyson

Title

Owner

Phone

(505) 860-5180

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 1

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

• Katherine Jeanne Piel, FNP-C

  • Primary Care Nurse Practitioner
  • Durango, CO
  • NPI 1134937964

  NM

  Medicare reassignment NPD

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1003464652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 166",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874990166",
            "telephone_number": "505-787-2680",
            "fax_number": "505-787-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 E 20TH ST STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874014281",
            "telephone_number": "505-787-2680",
            "fax_number": "505-787-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINON HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "DIKILYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-860-5180"
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN PROGRESS",
            "identifier": "0000000000000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Farmington",
            "affiliation": "N",
            "address_1": "904 E 20th St Ste B",
            "city": "Farmington",
            "state": "NM",
            "country_code": "US",
            "postal_code": "874014281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Noreen J Pichardo, MSW
• Mary Pickard, PA-C
• Casey Blue Pike, PSR
• Zoe Celeste Pinckley
• Pinon Family Practice PC
• Pinon Hills Dental
• Pinon Hills Ear Nose and Throat Associates PA
• Pinon Hills Optical Inc
• Pinon Rose Counseling
• Pinon Sleep Center, LLC

• Sleep Medicine (Family Medicine) Physician in Farmington, NM
• Providers in Farmington, NM by specialty
• Sleep Medicine (Family Medicine) Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.