Active NPI
Consuelo Cruz
- Speech-Language Pathologist
- Mora, NM
National Provider Identifier
1376676338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 122095
- Practice address
- Hwy 518 Ranger Rd.
Mora, NM 87732 - Phone
- (505) 387-3307
- NPI assigned
- Mar 13, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 122095 | NM | Primary |
Addresses
Primary practice location
Hwy 518 Ranger Rd.
Mora, NM 87732
Mailing address
PO Box 94
Holman, NM 87723-0094
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 |
|---|---|---|---|
| 122095 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mora Independent School | Speech-Language Pathologist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Speech-Language Pathologist
- Mora, NM
- NPI 1952434540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376676338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 94",
"city": "HOLMAN",
"state": "NM",
"postal_code": "877230094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HWY 518 RANGER RD.",
"city": "MORA",
"state": "NM",
"postal_code": "87732",
"telephone_number": "505-387-3307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "CONSUELO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "122095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mora, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.