Individual provider Active NPI

Diandra Little Dog, MD

  • Family Medicine Physician
  • Rio Rancho, NM
National Provider Identifier
1275114126
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2026-0726 Issued in NM
Practice address
3001 Broadmoor Blvd NE
Rio Rancho, NM 87144-2100
Phone
(505) 994-7000
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2026-0726 NM Primary

Addresses

Primary practice location

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144-2100

Mailing address

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144-2100
Phone (505) 994-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210628002384 MN Order and Referring Only - General SurgeryPractitioner - Family PracticePractitioner - General Surgery 4688075633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1275114126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 BROADMOOR BLVD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871442100",
            "telephone_number": "505-994-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 BROADMOOR BLVD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871442100",
            "telephone_number": "505-994-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE DOG",
        "first_name": "DIANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2026-0726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.