Active NPI
Sarah Durgam
- Pediatrics Physician
- Holloman AFB, NM
National Provider Identifier
1689137770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101270695
- Practice address
- 280 1St St
Holloman AFB, NM 88330-8273 - Phone
- (575) 572-3069
- NPI assigned
- Apr 7, 2019
- Last updated
- Jun 21, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101270695 | VA | Primary |
Addresses
Primary practice location
280 1St St
Holloman AFB, NM 88330-8273
Mailing address
280 1St St
Holloman AFB, NM 88330-8273
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101270695 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1689137770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 1ST ST",
"city": "HOLLOMAN AFB",
"state": "NM",
"postal_code": "883308273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 1ST ST",
"city": "HOLLOMAN AFB",
"state": "NM",
"postal_code": "883308273",
"telephone_number": "575-572-3069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURGAM",
"first_name": "SARAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-07",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101270695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holloman AFB, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.