Active NPI
Jack Shoup Garland, M.D.
- Anatomic Pathology Physician
- Taos, NM
National Provider Identifier
1538340005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 2002-0370
- Practice address
- 1397 Weimer Rd
Taos, NM 87571-6284 - Phone
- (505) 751-5884
- Fax
- (505) 737-3398
- NPI assigned
- Nov 26, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 2002-0370 | NM | Primary |
Addresses
Primary practice location
1397 Weimer Rd
Taos, NM 87571-6284
Mailing address
1397 Weimer Rd
Taos, NM 87571-6284
Phone (505) 751-5884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002-0370 | NM | MD | Anatomic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196035200000",
"number": "1538340005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1397 WEIMER RD",
"city": "TAOS",
"state": "NM",
"postal_code": "875716284",
"telephone_number": "505-751-5884",
"fax_number": "505-737-3398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1397 WEIMER RD",
"city": "TAOS",
"state": "NM",
"postal_code": "875716284",
"telephone_number": "505-751-5884",
"fax_number": "505-737-3398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARLAND",
"first_name": "JACK",
"middle_name": "SHOUP",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-26",
"last_updated": "2007-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "NM",
"license": "2002-0370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.