Jonathan C Peachey, CFNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R36036 Issued in NM

Practice address

1010 Spruce St
Espanola Hospital
Espanola, NM 87532-2724

Phone

(505) 753-7111

Fax

(505) 753-4438

NPI assigned

Mar 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184749970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SPRUCE ST",
            "address_2": "ESPANOLA HOSPITAL",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322724",
            "telephone_number": "505-753-7111",
            "fax_number": "505-753-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACHEY",
        "first_name": "JONATHAN",
        "middle_name": "C",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "R36036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K6225",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth Mary Oswood, LPCC
• Suzanne Otter, MA
• Daisy Pacheco, RDH
• Katrina Ann Padilla
• Damien Salvatore Passalacqua, D.C.
• Bailey Pearson, FNP-C
• Michelle Peixinho, LMSW, LM, CPM
• Lucie Margaret Hamel Pepper, BA
• Fabiola Perez, RPH
• Susan J. Perry, PH.D.,CDC

• Nurse Practitioner in Espanola, NM
• Providers in Espanola, NM by specialty
• Nurse Practitioner in New Mexico

• 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.

Verify at the official NPI Registry.