Individual provider Active NPI

Justin Shuya

  • Registered Nurse
  • Santa Fe, NM
National Provider Identifier
1053121327
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1045932 Issued in TX
Practice address
2504 Camino Entrada
Santa Fe, NM 87507-4851
Phone
(505) 847-5422
NPI assigned
Jan 9, 2025
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1045932 TX Primary

Addresses

Primary practice location

2504 Camino Entrada
Santa Fe, NM 87507-4851

Mailing address

5184 Memory Dr
El Paso, TX 79932-2246
Phone (915) 474-5384

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
1045932TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1053121327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5184 MEMORY DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799322246",
            "telephone_number": "915-474-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 CAMINO ENTRADA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074851",
            "telephone_number": "505-847-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUYA",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1045932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.