Samantha Gallegos-Gollihugh, CNM
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Albuquerque, NM
NPI 1780129403 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1780129403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 71421 (NM)
- Practice address
- 201 Cedar St SE Ste 405
Albuquerque, NM 87106-4924 - Phone
- (505) 764-9535
- NPI assigned
- Jan 4, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170410000718 | NM | Practitioner - Certified Nurse Midwife (CNM) | 3678859436 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71421 | NM | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Perinatal Associates of New Mexico, LTD | Current |
Accepting new patients | |
| Perinatal Associates of New Mexico, LTD | Past |
Accepting new patients |
Locations
201 Cedar St SE
Ste 405
Albuquerque, NM 87106
Phone (505) 764-9535
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
454 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 303-5000
Interoperability endpoints
- samantha.gallegos-gollihugh@panm.directbygreenway.com
- sgallegosgollihugh127153@direct.phs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | NM | ||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71421 | NM | Yes |
Addresses
Primary practice location
201 Cedar St SE Ste 405
Albuquerque, NM 87106-4924
Mailing address
201 Cedar St SE Ste 405
Albuquerque, NM 87106-4924
Phone (505) 764-9535
Other providers in Albuquerque, NM
- Daniel Fernando Gallego Umana
- Maria Rebecca Gallego
- Gallegos Endodontics LLC
- Gallegos Family Dentistry
- Rosa Gallegos Samora
- Angela Gallegos-Macias
- Adam Gallegos
- Alegre Gallegos
- Alek Gallegos
- Amanda Gallegos
All providers in Albuquerque, NM · Psychiatric/Mental Health Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.