Antonia Hernandez, CPNP, RN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

59822 Issued in NM

Practice address

2111 College Dr
Gallup, NM 87301-5600

Phone

(505) 863-1820

NPI assigned

Sep 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FBBICD

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.

• Rehoboth McKinley Christian Health Care Services, Inc

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1689784506
  Medicare reassignment NPD
• Rehoboth McKinley Christian Health Care Services, Inc

  • Rural Health Clinic/Center
  • Gallup, NM
  • NPI 1689779860
  NPD
• Rehoboth McKinley Christian Health Care Services, Inc.

  dba RMCHCS Hospital

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1720084999
  NPD
• Gallup Community Health

  • Federally Qualified Health Center (FQHC)
  • Gallup, NM
  • NPI 1336807254
  NPD (past)

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1306215926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 COLLEGE DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015600",
            "telephone_number": "505-863-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 COLLEGE DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015600",
            "telephone_number": "505-863-1820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 E Nizhoni Blvd",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873015748",
            "country_code": "US",
            "telephone_number": "505-722-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ANTONIA",
        "credential": "CPNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NM",
            "license": "R67661",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NM",
            "license": "59822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mac Henry, MD
• William S Henry, RN
• Kia Her, RN
• Maureen May Tecson Herbas
• Carol Ann Heredia, LMSW
• Christina Hernandez, LSAA, CHW
• Jemimah Hernandez, RN
• Thomas John Herr, MD
• Laurie Shannon Herrin, RN
• Lauren Michelle Hertzog, PHARMD

• Pediatric Nurse Practitioner in Gallup, NM
• Providers in Gallup, NM by specialty
• Pediatric Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.