Individual provider Active NPI

Reynaldo Almadin Jornacion, MT

  • Medical Technologist
  • Harlem, MT
National Provider Identifier
1104047257
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
04040536 Issued in VA
Practice address
RR1 Box 67
Harlem, MT 59526
Phone
(406) 353-3100
Fax
(406) 353-3229
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X 04040536 VA Primary

Addresses

Primary practice location

RR1 Box 67
Harlem, MT 59526

Mailing address

RR1 Box 1602
Harlem, MT 59526
Phone (406) 353-4754

Other identifiers 1

IdentifierTypeStateIssuer
04040536OtherMTLICENSE

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
Medical Technician

State licenses

LicenseStateTypeSpecialty
04040536VAMDMedical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104047257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR1 BOX 1602",
            "city": "HARLEM",
            "state": "MT",
            "postal_code": "59526",
            "telephone_number": "406-353-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR1 BOX 67",
            "city": "HARLEM",
            "state": "MT",
            "postal_code": "59526",
            "telephone_number": "406-353-3100",
            "fax_number": "406-353-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORNACION",
        "first_name": "REYNALDO",
        "middle_name": "ALMADIN",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "VA",
            "license": "04040536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "04040536",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlem, MT

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.

Verify at the official NPI Registry.