NPIMap

Organization Active NPI

San Juan Nephrology

  • Nephrology Physician
  • Farmington, NM
National Provider Identifier
1104903434
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SAN JUAN NEPHROLOGY
Practice address
634 W Pinon St
Farmington, NM 87401-5915
Phone
(866) 541-3690
Fax
(866) 541-3691
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Marjorie Gayle Murphy, M.D.NPI 1356388334
Title
Member
Phone
(866) 541-3690

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

634 W Pinon St
Farmington, NM 87401-5915

Mailing address

PO Box 526
Albuquerque, NM 87103-0526
Phone (866) 541-3690

Other identifiers 5

IdentifierTypeStateIssuer
SAS65104OtherCOCO BCBS
95023071MedicaidCO
502121MedicaidAZ
76102MedicaidNM
7388OtherNMNM BCBS

National Provider Directory

National Provider Directory

Locations

634 W Pinon St
Farmington, NM 87401
Phone (505) 325-4898

Practitioners & affiliated clinicians

Practitioners 3

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1104903434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 526",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871030526",
            "telephone_number": "866-541-3690",
            "fax_number": "866-541-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 W PINON ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015915",
            "telephone_number": "866-541-3690",
            "fax_number": "866-541-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN NEPHROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_middle_name": "GAYLE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "866-541-3690",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO BCBS",
            "identifier": "SAS65104",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95023071",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502121",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76102",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM BCBS",
            "identifier": "7388",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.