Northern NM Gastroenterology

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

PA2014-0057 Issued in NM

Legal business name

NORTHERN NM GASTROENTEROLOGY

Practice address

1691 Galisteo St
Suite C
Santa Fe, NM 87505-4780

Phone

(505) 983-5631

Fax

(505) 982-5605

NPI assigned

Oct 27, 2014

Last updated

Oct 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karen R Conner, PA-CNPI 1669879771

Title

PA-C

Phone

(505) 983-5631

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Karen Conner, PA-C

  • Physician Assistant
  • Santa Fe, NM
  • NPI 1669879771
  Authorized official Same address or phone
• Alejandra I Castillo-Roth, M.D.

  • Gastroenterology Physician
  • Santa Fe, NM
  • NPI 1124222401
  NPD

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1477958973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 GALISTEO ST",
            "address_2": "SUITE C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054780",
            "telephone_number": "505-983-5631",
            "fax_number": "505-982-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 GALISTEO ST",
            "address_2": "SUITE C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054780",
            "telephone_number": "505-983-5631",
            "fax_number": "505-982-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NM GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "505-983-5631",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NM",
            "license": "PA2014-0057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern New Mexico Hearing and Balance Institute, LLC
• Northern New Mexico Neuropsychology LLC
• Northern New Mexico Periodontal Assoc.
• Northern New Mexico Podiatry Assoc.
• Northern New Mexico Vascular Lab Inc.
• Northern NM Medical Management, LLC
• Frederic W Northern, PA-C
• Karan Northfield
• Northland Hearing Centers Inc (Advanced Hearing Clinics)
• Northland Hearing Centers, Inc (Soundpoint Audiology & Hearing)

• Medical Specialty Clinic/Center in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Medical Specialty Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.

Verify at the official NPI Registry.