Active NPI
Bob Montoya, CST SFA
- Surgical Technologist
- Farmington, NM
National Provider Identifier
1174665137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 01-135
- Practice address
- 2300 E 30TH St BLDG a
Farmington, NM 87401-8991 - Phone
- (505) 564-2300
- Fax
- (505) 564-2210
- NPI assigned
- Feb 13, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 01-135 | NM | Primary |
Addresses
Primary practice location
2300 E 30TH St BLDG a
Farmington, NM 87401-8991
Mailing address
2300 E 30TH St BLDG a
Farmington, NM 87401-8991
Phone (505) 564-2300
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01-135 | NM | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174665137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 E 30TH ST BLDG A",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874018991",
"telephone_number": "505-564-2300",
"fax_number": "505-564-2210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 E 30TH ST BLDG A",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874018991",
"telephone_number": "505-564-2300",
"fax_number": "505-564-2210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTOYA",
"first_name": "BOB",
"credential": "CST SFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "NM",
"license": "01-135",
"primary": true
}
],
"identifiers": [],
"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 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.