Active NPI
Wanicha Buraphacheep-Coggins, M.D.
- Pediatric Infectious Diseases Physician
- Santa Fe, NM
National Provider Identifier
1083736136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Infectious Diseases Physician
- License
- 98-34
- Practice address
- 2040 S Pacheco St
NM Doh Family Planning Program
Santa Fe, NM 87505-5472 - Phone
- (505) 476-8870
- Fax
- (505) 476-8898
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Infectious Diseases Physician | 2080P0208X | 98-34 | NM | Primary |
Addresses
Primary practice location
2040 S Pacheco St
NM Doh Family Planning Program
Santa Fe, NM 87505-5472
Mailing address
2040 S Pacheco St
NM Doh Family Planning Program
Santa Fe, NM 87505-5472
Phone (505) 476-8870
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 98-34 | NM | MD | Pediatric Infectious Diseases Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083736136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 S PACHECO ST",
"address_2": "NM DOH FAMILY PLANNING PROGRAM",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875055472",
"telephone_number": "505-476-8870",
"fax_number": "505-476-8898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 S PACHECO ST",
"address_2": "NM DOH FAMILY PLANNING PROGRAM",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875055472",
"telephone_number": "505-476-8870",
"fax_number": "505-476-8898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURAPHACHEEP-COGGINS",
"first_name": "WANICHA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "NM",
"license": "98-34",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.