Organization Active NPI

Sierra Dermatology PC

  • Dermatology Physician
  • Silver City, NM
National Provider Identifier
1255378097
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SIERRA DERMATOLOGY PC
Practice address
3060 Highway 180 E
Silver City, NM 88061-7703
Phone
(575) 388-2743
Fax
(575) 388-8885
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Authorized official

Name
Gilbert S Arizaga, MD
Title
Owner
Phone
(575) 388-2743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3060 Highway 180 E
Silver City, NM 88061-7703

Mailing address

3060 Highway 180 E
Silver City, NM 88061-7703
Phone (575) 388-2743

Other identifiers 1

IdentifierTypeStateIssuer
00001768MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1255378097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 HIGHWAY 180 E",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880617703",
            "telephone_number": "575-388-2743",
            "fax_number": "575-388-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 HIGHWAY 180 E",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880617703",
            "telephone_number": "575-388-2743",
            "fax_number": "575-388-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "ARIZAGA",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-388-2743",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001768",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.