Individual provider Active NPI

Marianne Laura Hafer, DOM

  • Acupuncturist
  • Santa Fe, NM
National Provider Identifier
1770693764
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
243 Issued in NM
Practice address
1207 Morelia St
Santa Fe, NM 87505-4129
Phone
(505) 820-0764
Fax
(505) 989-9953
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 243 NM Primary

Addresses

Primary practice location

1207 Morelia St
Santa Fe, NM 87505-4129

Mailing address

1207 Morelia St
Santa Fe, NM 87505-4129
Phone (505) 820-0764

Other identifiers 1

IdentifierTypeStateIssuer
R624OtherNMBCBS OF NM

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

LicenseStateTypeSpecialty
243NMMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770693764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 MORELIA ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054129",
            "telephone_number": "505-820-0764",
            "fax_number": "505-989-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MORELIA ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054129",
            "telephone_number": "505-820-0764",
            "fax_number": "505-989-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFER",
        "first_name": "MARIANNE",
        "middle_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "DOM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NM",
            "identifier": "R624",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.