Ivan Teodoro Chia

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN-80640 Issued in NM

Practice address

US Hwy 491 North
Shiprock, NM 87420-0160

Phone

(505) 368-6001

NPI assigned

Dec 20, 2018

Last updated

Dec 20, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1093287609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 WOODLAND DR STE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781737",
            "telephone_number": "317-286-2885",
            "fax_number": "317-536-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 491 NORTH",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIA",
        "first_name": "IVAN",
        "middle_name": "TEODORO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "718779",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-80640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rubie M Chase, PHARMD
• Jonathan Michael Chavez, PHARMD
• Stacy Chen, PHARMD
• Christopher J. Chevalier, PHARMD
• Crystal CHI, PHARMD
• Sylvia Clahchischilli, MFT
• Harry Clark Jr.
• Delphine Y Clashin, LPCC
• Paula P Claw, LCSW, MPA
• Vicky Cline

• Registered Nurse in Shiprock, NM
• Providers in Shiprock, NM by specialty
• Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.