Individual provider Active NPI

Jesse Montoya

  • Community Health Worker
  • Las Vegas, NM
National Provider Identifier
1558785808
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
700 Friedman Ave
Las Vegas, NM 87701-4231
Phone
(505) 454-5100
NPI assigned
Feb 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

700 Friedman Ave
Las Vegas, NM 87701-4231

Mailing address

700 Friedman Ave
Las Vegas, NM 87701-4231
Phone (505) 454-5100

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

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1558785808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 FRIEDMAN AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014231",
            "telephone_number": "505-454-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 FRIEDMAN AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014231",
            "telephone_number": "505-454-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "JESSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-06",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.