Family Practice Medical and Dietetic Medical Therapy

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

CNP00942 Issued in NM

Legal business name

FAMILY PRACTICE MEDICAL AND DIETETIC MEDICAL THERAPY

Practice address

2904 Hillrise Dr
Las Cruces, NM 88011-4702

Phone

(575) 532-5386

Fax

(575) 532-5449

NPI assigned

Mar 8, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jose Rosales, NP

Title

Owner

Phone

(575) 532-5386

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364515200000",
    "number": "1609199447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 HILLRISE DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114702",
            "telephone_number": "575-532-5386",
            "fax_number": "575-532-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 HILLRISE DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114702",
            "telephone_number": "575-532-5386",
            "fax_number": "575-532-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE MEDICAL AND DIETETIC MEDICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-08",
        "last_updated": "2013-03-29",
        "status": "A",
        "authorized_official_last_name": "ROSALES",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-532-5386",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT06119",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "LD0748",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NM",
            "license": "CNP00942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1609199447",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58878335",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evangelia S Falkner, CNM, PMHNP-BC
• Familia Dental Las Cruces LLC
• Families & Youth, Inc
• Families and Youth Inc
• Family Pharmacy, LLC
• Family Pride Foundation Treatment
• Family Youth Inc
• Familycare Associates,PA
• Muhammad Farhan, DO
• Farnsworth Orthodontics Las Cruces LLC

• Primary Care Nurse Practitioner in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Primary Care Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; 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.