Active NPI
Nicholas Nillo, M.D.
- General Practice Physician
- Las Cruces, NM
National Provider Identifier
1679711121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 8074
- Practice address
- 307 Sanchez PL
Las Cruces, NM 88005-3795 - Phone
- (575) 541-9376
- NPI assigned
- Jan 21, 2009
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 8074 | NM | Primary |
Addresses
Primary practice location
307 Sanchez PL
Las Cruces, NM 88005-3795
Mailing address
307 Sanchez PL
Las Cruces, NM 88005-3795
Phone (575) 541-9376
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8074 | NM | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232496000000",
"number": "1679711121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 SANCHEZ PL",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053795",
"telephone_number": "575-541-9376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 SANCHEZ PL",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053795",
"telephone_number": "575-541-9376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NILLO",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-21",
"last_updated": "2009-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NM",
"license": "8074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.