Individual provider Active NPI

Jonny Lorraine Salyer, M.D.

  • Clinical Pathology Physician
  • Albuquerque, NM
National Provider Identifier
1548675473
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
91-297 Issued in NM
Practice address
2441 Ridgecrest Dr SE
Albuquerque, NM 87108-5129
Phone
(505) 348-9500
NPI assigned
Jun 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology Physician 207ZC0006X 91-297 NM Primary

Addresses

Primary practice location

2441 Ridgecrest Dr SE
Albuquerque, NM 87108-5129

Mailing address

1600 Camino de la Sierra NE
Albuquerque, NM 87112-4938
Phone (317) 910-2402

Other names 1

  • Miss Jonny Lorraine Gibson Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
91-297NMMDClinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1548675473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CAMINO DE LA SIERRA NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871124938",
            "telephone_number": "317-910-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 RIDGECREST DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085129",
            "telephone_number": "505-348-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALYER",
        "first_name": "JONNY",
        "middle_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "NM",
            "license": "91-297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONNY",
            "last_name": "GIBSON",
            "middle_name": "LORRAINE",
            "prefix": "MISS",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.