Active NPI
Robert Le Alan Shaffer, FNP
- Family Nurse Practitioner
- Artesia, NM
National Provider Identifier
1275504425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 59325
- Practice address
- 1105 Memorial Dr
Artesia, NM 88210-1189 - Phone
- (575) 746-9848
- Fax
- (575) 746-2215
- NPI assigned
- Jan 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 59325 | CO | Primary |
Addresses
Primary practice location
1105 Memorial Dr
Artesia, NM 88210-1189
Mailing address
911 Robinson Ave
Trinidad, CO 81082-2811
Phone (719) 845-4884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59325 | CO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Front Range Primary Care Partners LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Trinidad, CO
- NPI 1043584253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1275504425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 ROBINSON AVE",
"city": "TRINIDAD",
"state": "CO",
"postal_code": "810822811",
"telephone_number": "719-845-4884",
"fax_number": "719-846-8209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 MEMORIAL DR",
"city": "ARTESIA",
"state": "NM",
"postal_code": "882101189",
"telephone_number": "575-746-9848",
"fax_number": "575-746-2215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "ROBERT",
"middle_name": "LE ALAN",
"name_prefix": "Mr.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "59325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Artesia, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.