Active NPI
Kathryn Perea
- Registered Nurse
- Los Lunas, NM
National Provider Identifier
1396295606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R20397
- Practice address
- 1044 Balboa CT SE
Los Lunas, NM 87031-9240 - Phone
- (505) 966-1306
- Fax
- (505) 966-1350
- NPI assigned
- Oct 11, 2016
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R20397 | NM | Primary |
Addresses
Primary practice location
1044 Balboa CT SE
Los Lunas, NM 87031-9240
Mailing address
1044 Balboa CT SE
Los Lunas, NM 87031-9240
Phone (505) 966-1306
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 |
|---|---|---|---|
| R20397 | NM | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1396295606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1044 BALBOA CT SE",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "870319240",
"telephone_number": "505-966-1306",
"fax_number": "505-966-1350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1044 BALBOA CT SE",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "870319240",
"telephone_number": "505-966-1306",
"fax_number": "505-966-1350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREA",
"first_name": "KATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-11",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "R20397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Lunas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.