NPIMap

Organization Active NPI

GRD Health Clinic LLC

  • Acupuncturist
  • Espanola, NM
National Provider Identifier
1124315577
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
444 Issued in NM
Legal business name
GRD HEALTH CLINIC LLC
Practice address
510 N Paseo de Onate
Espanola, NM 87532-2618
Phone
(505) 753-3369
Fax
(505) 753-4006
NPI assigned
Jul 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Authorized official

Name
Mrs. Jiwan Khalsa, DOM RX2
Title
Domrx2
Phone
(505) 753-3369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X 444 NM Primary

Addresses

Primary practice location

510 N Paseo de Onate
Espanola, NM 87532-2618

Mailing address

510 N Paseo de Onate
Espanola, NM 87532-2618
Phone (505) 753-3369

National Provider Directory

National Provider Directory

Locations

510 N Paseo de Onate
Espanola, NM 87532
Phone (505) 753-3369

Practitioners & affiliated clinicians

Practitioners 5

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": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1124315577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322618",
            "telephone_number": "505-753-3369",
            "fax_number": "505-753-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322618",
            "telephone_number": "505-753-3369",
            "fax_number": "505-753-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRD HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "KHALSA",
        "authorized_official_first_name": "JIWAN",
        "authorized_official_title_or_position": "DOMRX2",
        "authorized_official_telephone_number": "505-753-3369",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DOM RX2"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Espanola, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.