Individual provider Active NPI

Dannial Rene Coston

  • Family Nurse Practitioner
  • Los Lunas, NM
National Provider Identifier
1235881145
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
65970 Issued in NM
Practice address
1202 Main St NE Ste a
Los Lunas, NM 87031-7421
Phone
(505) 565-0070
NPI assigned
Jan 21, 2022
Last updated
Jan 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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 65970 NM Primary

Addresses

Primary practice location

1202 Main St NE Ste a
Los Lunas, NM 87031-7421

Mailing address

12127 N State Hwy 14 Ste 5
Cedar Crest, NM 87008-9461
Phone (505) 281-2460

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
I20220421002353 NM Practitioner - Nurse Practitioner 2961899901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLeod Medical Centers of NM IncGroup PAC ID 5092075531, 54 clinicians

Practice addresses (Care Compare)

1851 Old Hwy 66
Edgewood, NM 87015-6784
Phone (505) 281-5180

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Medical Centers of NM, Inc. CurrentSince Feb 15, 2022 Accepting new patients
McLeod Medical Centers of NM, Inc. CurrentSince Feb 15, 2022 Accepting new patients

Locations

12127 N State Highway 14
Ste 5
Cedar Crest, NM 87008
Phone (505) 281-2460

1202 Main St NE
Ste A
Los Lunas, NM 87031
Phone (505) 565-0070

Interoperability endpoints

  • Direct secure messaging: dannial.coston.1@27050.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1235881145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12127 N STATE HWY 14 STE 5",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870089461",
            "telephone_number": "505-281-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MAIN ST NE STE A",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317421",
            "telephone_number": "505-565-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTON",
        "first_name": "DANNIAL",
        "middle_name": "RENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "65970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

Verify at the official NPI Registry.