Individual provider Active NPI

Taffeta Troutner, NP

  • Family Nurse Practitioner
  • Farmington, NM
National Provider Identifier
1205280096
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-02911 Issued in NM
Practice address
2300 E 30TH St Ste B-102
Farmington, NM 87401-8991
Phone
(505) 609-6790
Fax
(505) 599-4640
NPI assigned
Apr 18, 2016
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP-02911 NM Primary

Addresses

Primary practice location

2300 E 30TH St Ste B-102
Farmington, NM 87401-8991

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other practice location 1

4820 E Main St
Farmington, NM 87402-8660
Phone (505) 609-6495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613000389 NM Practitioner - Nurse Practitioner 5799075230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Llano St
Aztec, NM 87410-2172
Phone (505) 334-3404

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc CurrentSince May 2, 2016 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
San Juan Regional Medical Center Inc CurrentSince May 2, 2016 Accepting new patients
San Juan Regional Medical Center Inc Past Accepting new patients

Locations

120 Llano St
Aztec, NM 87410
Phone (505) 334-3404

2300 E 30th St
Ste B-102
Farmington, NM 87401
Phone (505) 327-4044

407 S Schwartz Ave
Ste 101
Farmington, NM 87401
Phone (505) 609-6595

4820 E Main St
Farmington, NM 87402
Phone (505) 326-0459

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1205280096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST STE B-102",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018991",
            "telephone_number": "505-609-6790",
            "fax_number": "505-599-4640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4820 E Main St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874028660",
            "country_code": "US",
            "telephone_number": "505-609-6495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TROUTNER",
        "first_name": "TAFFETA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-02911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.