Mary Loring Daggett, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

95-PA30 Issued in NM

Practice address

Bikini Atoll Road Ms D421
Los Alamos, NM 87545

Phone

(505) 665-2631

NPI assigned

Mar 28, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lori Daggett Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1265551469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 CALLE PINTURA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055273",
            "telephone_number": "505-471-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BIKINI ATOLL ROAD MS D421",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "87545",
            "telephone_number": "505-665-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGGETT",
        "first_name": "MARY",
        "middle_name": "LORING",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "95-PA30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K3602",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "DAGGETT",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Catharyn Dianne Crall, MS, LMHC, NCC
• Mary Eisele Cummings, PH.D.
• Curtis a Brookover, DDS, PC (Alpine Laser Dental)
• Leslie Michelle Cutrer, LMHC
• Amelyn D'Egidio, CERT MLD THERAPIST
• Paul Daly, MD
• David C. Hobson, DDS, Ms a Professional Corporation (David C. Hobson, DDS)
• Deepa Nadiga MD
• Desert Sky Therapy Services, LLC
• Deborah Desimone

• Medical Physician Assistant in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.