NPIMap

Organization Active NPI

Peter Sangra MD LLC

  • Child & Adolescent Psychiatry Physician
  • Santa Teresa, NM
National Provider Identifier
1306464615
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
PETER SANGRA MD LLC
Practice address
5055 McNutt Rd
Santa Teresa, NM 88008-9442
Phone
(575) 589-3000
NPI assigned
Jul 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Peter Sangra, MDNPI 1265873947
Title
Owner
Phone
(404) 513-2350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

5055 McNutt Rd
Santa Teresa, NM 88008-9442

Mailing address

2004 Boy Scout LN
Sunland Park, NM 88063-9500
Phone (404) 513-2350

Other practice location 1

2004 Boy Scout Ln
Sunland Park, NM 88063-9500
Phone (404) 513-2350

Other practice location 2

5045 McNutt Rd
Santa Teresa, NM 88008-9442
Phone (575) 589-3000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1306464615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 BOY SCOUT LN",
            "city": "SUNLAND PARK",
            "state": "NM",
            "postal_code": "880639500",
            "telephone_number": "404-513-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 MCNUTT RD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089442",
            "telephone_number": "575-589-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2004 Boy Scout Ln",
            "address_purpose": "LOCATION",
            "city": "Sunland Park",
            "state": "NM",
            "postal_code": "880639500",
            "country_code": "US",
            "telephone_number": "404-513-2350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5045 McNutt Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Teresa",
            "state": "NM",
            "postal_code": "880089442",
            "country_code": "US",
            "telephone_number": "575-589-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PETER SANGRA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "SANGRA",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-513-2350",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Teresa, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.