Active NPI
Hospice of the Southwest Albq Inc
- Hospice and Palliative Medicine (Family Medicine) Physician
- Albuquerque, NM
National Provider Identifier
1194491209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Family Medicine) Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6483194 | Other | NM | CERTIFICATE OF INCORPORATION |
National Provider Directory
National Provider DirectoryNPI 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.