Village of San Jon

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

02690 Issued in NM

Legal business name

VILLAGE OF SAN JON

Practice address

414 E. Elm
San Jon, NM 88434

Phone

(505) 576-2922

Fax

(505) 576-2722

NPI assigned

Apr 23, 2007

Last updated

Aug 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Debbie L. Stoner, EMT-I

Title

Official

Phone

(575) 403-8463

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• San Jon Cooperative Ambulance Other name

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1740408756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 FARNAM DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543237",
            "telephone_number": "877-218-4392",
            "fax_number": "877-343-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E. ELM",
            "city": "SAN JON",
            "state": "NM",
            "postal_code": "88434",
            "telephone_number": "505-576-2922",
            "fax_number": "505-576-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF SAN JON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "STONER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICIAL",
        "authorized_official_telephone_number": "575-403-8463",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT-I"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NM",
            "license": "02690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "02690",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Jon Cooperative Ambulance",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "San Jon Cooperative Ambulance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Loriella Haden, RN
• Regional Educational Center #6 (San Jon School Based Clinic)
• San Jon School Based Health Center
• Jaimie Alicia Sanchez, RN
• Helen Louise Snapp
• Amber Marie Watson, LPN
• Lynda Gayle White, RN

• Land Ambulance in San Jon, NM
• Providers in San Jon, NM by specialty
• Land Ambulance in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.