Active NPI
Srikanta Mishra, PHD
- Audiologist
- Las Cruces, NM
National Provider Identifier
1417351545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 5641
- Practice address
- 1405 International Mall
Speech Building Room 158
Las Cruces, NM 88003 - Phone
- (575) 646-3906
- Fax
- (575) 646-7712
- NPI assigned
- Oct 17, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 5641 | NM | Primary |
Addresses
Primary practice location
1405 International Mall
Speech Building Room 158
Las Cruces, NM 88003
Mailing address
PO Box 30001, MSC 3Spe, New Mexico State University
Department of Sped & Communication Disorders
Las Cruces, NM 88003-8001
Phone (575) 646-7831
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5641 | NM | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413504000000",
"number": "1417351545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30001, MSC 3SPE, NEW MEXICO STATE UNIVERSITY",
"address_2": "DEPARTMENT OF SPED & COMMUNICATION DISORDERS",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880038001",
"telephone_number": "575-646-7831",
"fax_number": "575-646-7712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 INTERNATIONAL MALL",
"address_2": "SPEECH BUILDING ROOM 158",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "88003",
"telephone_number": "575-646-3906",
"fax_number": "575-646-7712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISHRA",
"first_name": "SRIKANTA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-17",
"last_updated": "2014-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NM",
"license": "5641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.