Individual provider Active NPI

Donna J Rich, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gallup, NM
National Provider Identifier
1114293065
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP-03267 Issued in NM
Practice address
2025 E Aztec Ave
Gallup, NM 87301-4803
Phone
(432) 888-4130
NPI assigned
Mar 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP-03267 NM
Family Nurse Practitioner 363LF0000X 517963 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP121154 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP-03267 NM Primary

Addresses

Primary practice location

2025 E Aztec Ave
Gallup, NM 87301-4803

Mailing address

2025 E Aztec Ave
Gallup, NM 87301-4803

Other practice location 1

413 SE 1st St
Andrews, TX 79714-8104
Phone (432) 888-4130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230915003369 NM Practitioner - Nurse Practitioner 0840570180 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
517963TXMDFamily Nurse Practitioner
AP121154TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services CurrentSince Jul 17, 2023 Accepting new patients
Presbyterian Medical Services CurrentSince Jul 17, 2023 Accepting new patients
Presbyterian Medical Services Current Accepting new patients

Locations

2025 E Aztec Ave
Gallup, NM 87301
Phone (505) 863-3120

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Interoperability endpoints

  • Direct secure messaging: donna.rich.1@30520.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1114293065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014803",
            "telephone_number": "432-888-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 SE 1st St",
            "address_purpose": "LOCATION",
            "city": "Andrews",
            "state": "TX",
            "postal_code": "797148104",
            "country_code": "US",
            "telephone_number": "432-888-4130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICH",
        "first_name": "DONNA",
        "middle_name": "J",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-03267",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "517963",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP121154",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP-03267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.