Active NPI
Shontelle Antoinette Lujan, LPN
- Licensed Practical Nurse
- Albuquerque, NM
National Provider Identifier
1740096155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 75475
- Practice address
- 2720 Broadbent Pkwy NE Ste a
Albuquerque, NM 87107-1623 - Phone
- (800) 237-6257
- NPI assigned
- Dec 10, 2024
- Last updated
- Dec 10, 2024
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 75475 | NM | Primary |
Addresses
Primary practice location
2720 Broadbent Pkwy NE Ste a
Albuquerque, NM 87107-1623
Mailing address
2525 Tingley Dr SW Apt 305
Albuquerque, NM 87104-1655
Phone (505) 819-7439
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 |
|---|---|---|---|
| 75475 | NM | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmerica Long-Term Care LLC | Past | Accepting new patients | |
| Pharmerica Long-Term Care LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1740096155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 TINGLEY DR SW APT 305",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871041655",
"telephone_number": "505-819-7439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 BROADBENT PKWY NE STE A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871071623",
"telephone_number": "800-237-6257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUJAN",
"first_name": "SHONTELLE",
"middle_name": "ANTOINETTE",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-10",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NM",
"license": "75475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.