Individual provider Active NPI

Jesse Hoover, D.O.M.

  • Acupuncturist
  • Santa Fe, NM
National Provider Identifier
1306035696
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
936 Issued in NM
Practice address
2241 Camino Carlos Rey
Suite #20
Santa Fe, NM 87507-5257
Phone
(505) 471-3778
NPI assigned
Oct 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 936 NM Primary

Addresses

Primary practice location

2241 Camino Carlos Rey
Suite #20
Santa Fe, NM 87507-5257

Mailing address

2241 Camino Carlos Rey
Suite #20
Santa Fe, NM 87507-5257
Phone (505) 471-3778

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
936NMMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1306035696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 CAMINO CARLOS REY",
            "address_2": "SUITE #20",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875075257",
            "telephone_number": "505-471-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 CAMINO CARLOS REY",
            "address_2": "SUITE #20",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875075257",
            "telephone_number": "505-471-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "D.O.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.