Individual provider Active NPI

Abdiel Latorre Melendez

  • Registered Nurse
  • Gallup, NM
National Provider Identifier
1487306445
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
81866 Issued in PR
Practice address
516 E Nizhoni Blvd,Gallup
Gallup, NM 87301
Phone
(505) 722-1000
NPI assigned
Jan 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 81866 PR Primary

Addresses

Primary practice location

516 E Nizhoni Blvd,Gallup
Gallup, NM 87301

Mailing address

516 E Nizhoni Blvd,Gallup
Navajo, NM 87301
Phone (505) 722-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://npiregistry.cms.hhs.gov/

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

LicenseStateTypeSpecialty
81866PRMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1487306445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD,GALLUP",
            "city": "NAVAJO",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-722-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD,GALLUP",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATORRE MELENDEZ",
        "first_name": "ABDIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "81866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://npiregistry.cms.hhs.gov/",
            "affiliation": "N",
            "endpointDescription": "https://npiregistry.cms.hhs.gov/",
            "address_1": "516 E Nizhoni Blvd,Gallup",
            "city": "Gallup",
            "state": "NM",
            "country_code": "US",
            "postal_code": "87301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.