Charisse Buchanan, AG-NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

CNP-03322 Issued in NM

Practice address

4601 College Blvd
Farmington, NM 87402-4699

Phone

(505) 566-4255

Fax

(505) 566-3770

NPI assigned

Aug 1, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rehoboth McKinley Christian Health Care Services, Inc

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1689784506
  Medicare reassignment NPD
• Rehoboth McKinley Christian Health Care Services, Inc

  • Rural Health Clinic/Center
  • Gallup, NM
  • NPI 1689779860
  NPD
• Rehoboth McKinley Christian Health Care Services, Inc.

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1720084999
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1477077345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 COLLEGE BLVD",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 COLLEGE BLVD",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024699",
            "telephone_number": "505-566-4255",
            "fax_number": "505-566-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "CHARISSE",
        "credential": "AG-NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP-03322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanice Brown
• Thomas Brown II
• Eric Gordon Bruce, DDS
• Charles E Bruerd, D.O.
• Bryce J. Hunter, D.C. P.C.
• Wendy K Buchanan
• Anna Victoria Buck, FNP
• Eric Buffington
• Keith Maxwell Bull, CRNA
• Nicole Bunner, LSAA

• Adult Health Nurse Practitioner in Farmington, NM
• Providers in Farmington, NM by specialty
• Adult Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.