Organization Active NPI

Hospice of the Southwest Albq Inc

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Albuquerque, NM
National Provider Identifier
1194491209
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
HOSPICE OF THE SOUTHWEST ALBQ INC
Practice address
5219 Fairfax Dr NW
Albuquerque, NM 87114-4661
Phone
(505) 903-1039
NPI assigned
Aug 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Jessie J Pann-Nava, AAS
Title
Secretary
Phone
(505) 903-1039

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary

Addresses

Primary practice location

5219 Fairfax Dr NW
Albuquerque, NM 87114-4661

Mailing address

5219 Fairfax Dr NW
Albuquerque, NM 87114-4661
Phone (505) 903-1039

Other identifiers 1

IdentifierTypeStateIssuer
6483194OtherNMCERTIFICATE OF INCORPORATION

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1194491209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 FAIRFAX DR NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144661",
            "telephone_number": "505-903-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 FAIRFAX DR NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144661",
            "telephone_number": "505-903-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF THE SOUTHWEST ALBQ INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "PANN-NAVA",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "505-903-1039",
        "authorized_official_credential": "AAS"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF INCORPORATION",
            "identifier": "6483194",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.