Active NPI
John Roybal
- Licensed Practical Nurse
- Santa Fe, NM
National Provider Identifier
1336495720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- L09836
- Practice address
- 2001 Chamisa St
Santa Fe, NM 87505-3441 - Phone
- (505) 982-2129
- Fax
- (505) 992-1149
- NPI assigned
- Aug 3, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L09836 | NM | Primary |
Addresses
Primary practice location
2001 Chamisa St
Santa Fe, NM 87505-3441
Mailing address
2001 Chamisa St
Santa Fe, NM 87505-3441
Phone (505) 982-2129
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
| License | State | Type | Specialty |
|---|---|---|---|
| L09836 | NM | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343952000000",
"number": "1336495720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 CHAMISA ST",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875053441",
"telephone_number": "505-982-2129",
"fax_number": "505-992-1149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 CHAMISA ST",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875053441",
"telephone_number": "505-982-2129",
"fax_number": "505-992-1149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYBAL",
"first_name": "JOHN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-03",
"last_updated": "2012-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NM",
"license": "L09836",
"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 Aug 3, 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.