Organization Active NPI

Hastaadi Neeznadiin Dba Gallup Health

  • Community Health Worker
  • Gallup, NM
National Provider Identifier
1073138244
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
HASTAADI NEEZNADIIN DBA GALLUP HEALTH
Practice address
1108 E Historic Highway 66
Gallup, NM 87301-5466
Phone
(505) 726-9642
Fax
(505) 726-9642
NPI assigned
Jun 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Mr. Scott Daniel BurgnerNPI 1952152514
Title
Director
Phone
(505) 726-9642

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary
Medical Laboratory TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 246RM2200X
Community Health Clinic/Center 261QC1500X

Addresses

Primary practice location

1108 E Historic Highway 66
Gallup, NM 87301-5466

Mailing address

1108 E Historic Highway 66
Gallup, NM 87301-5466
Phone (505) 726-9642

Other identifiers 1

IdentifierTypeStateIssuer
N0016486MedicaidNM

Other names 2

  • Gallup Health Doing business as
  • Gallup Health Cooperative Former legal business name

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2133123Hastaadi Neeznadiin Dba Gallup Health1108 E Historic Hwy 66, Gallup, NM 87301Certificate of waiverJul 5, 2027

National Provider Directory

National Provider Directory

Locations

1108 E Historic Highway 66
Gallup, NM 87301
Phone (505) 726-9642

600 E Coal Ave
Gallup, NM 87301
Phone 5057269642700

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1073138244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 E HISTORIC HIGHWAY 66",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015466",
            "telephone_number": "505-726-9642",
            "fax_number": "505-726-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 E HISTORIC HIGHWAY 66",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015466",
            "telephone_number": "505-726-9642",
            "fax_number": "505-726-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HASTAADI NEEZNADIIN DBA GALLUP HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-12",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "BURGNER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-726-9642",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246RM2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0016486",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gallup Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gallup Health Cooperative",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.