Individual provider Active NPI

Tomasita Sedillo, RN

  • School Registered Nurse
  • Albuquerque, NM
National Provider Identifier
1093282725
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN-74239 Issued in NM
Practice address
4050 118TH St SW
Albuquerque, NM 87121
Phone
(505) 253-0300
Fax
(505) 873-1723
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN-74239 NM Primary

Addresses

Primary practice location

4050 118TH St SW
Albuquerque, NM 87121

Mailing address

10629 Gentry LN SW
Albuquerque, NM 87121-3687
Phone (505) 227-9332

Other identifiers 1

IdentifierTypeStateIssuer
RN-74239OtherNMNURSING LICENSE

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-74239NMMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1093282725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10629 GENTRY LN SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871213687",
            "telephone_number": "505-227-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 118TH ST SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87121",
            "telephone_number": "505-253-0300",
            "fax_number": "505-873-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDILLO",
        "first_name": "TOMASITA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NM",
            "license": "RN-74239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "RN-74239",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.