Robert John Walantas, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP00794 Issued in NM

Practice address

2019 Galisteo St Ste J1
Santa Fe, NM 87505-2103

Phone

(505) 820-0446

Fax

(505) 820-6142

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1194740167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST STE J1",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052103",
            "telephone_number": "505-820-0446",
            "fax_number": "505-820-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST STE J1",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052103",
            "telephone_number": "505-820-0446",
            "fax_number": "505-820-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALANTAS",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "500800",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP00794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13454234",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; 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.