Active NPI
Aimee Zagon
- Adult Medicine Physician
- Santa Fe, NM
National Provider Identifier
1477057164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- PA-017
- Practice address
- 4311 Highway 14
Santa Fe, NM 87508-1530 - Phone
- (505) 827-8983
- NPI assigned
- Mar 19, 2018
- 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 |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | PA-017 | NM | Primary |
Addresses
Primary practice location
4311 Highway 14
Santa Fe, NM 87508-1530
Mailing address
110 W Lupita Rd
Santa Fe, NM 87505-4718
Phone (505) 984-3130
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 |
|---|---|---|---|
| PA-017 | NM | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521417600000",
"number": "1477057164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 W LUPITA RD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054718",
"telephone_number": "505-984-3130",
"fax_number": "505-984-3130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4311 HIGHWAY 14",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875081530",
"telephone_number": "505-827-8983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAGON",
"first_name": "AIMEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-19",
"last_updated": "2018-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "NM",
"license": "PA-017",
"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 Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.