Individual provider Active NPI

Pamela Rothe, RN, BSN

  • Registered Nurse
  • Sandia Park, NM
National Provider Identifier
1164179073
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
58642 Issued in NM
Practice address
25 Lamadera Rd.
Sandia Park, NM 87047-8704
Phone
(505) 281-7400
NPI assigned
Mar 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 58642 NM Primary

Addresses

Primary practice location

25 Lamadera Rd.
Sandia Park, NM 87047-8704

Mailing address

28 Kiva CT
Sandia Park, NM 87047-8514
Phone (720) 309-4729

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nurse@eastmountainhigh.net Direct

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
58642NMMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1164179073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 KIVA CT",
            "city": "SANDIA PARK",
            "state": "NM",
            "postal_code": "870478514",
            "telephone_number": "720-309-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LAMADERA RD.",
            "city": "SANDIA PARK",
            "state": "NM",
            "postal_code": "870478704",
            "telephone_number": "505-281-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHE",
        "first_name": "PAMELA",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "58642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nurse@eastmountainhigh.net",
            "affiliation": "N",
            "endpointDescription": "Health Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25 LaMadera Rd.",
            "city": "Sandia Park",
            "state": "NM",
            "country_code": "US",
            "postal_code": "870478704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sandia Park, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.