Roger L Leonard, RN

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

R54222 Issued in NM

Practice address

#85 West Hwy 22
Santo Domingo, NM 87052

Phone

(505) 465-3060

NPI assigned

Oct 10, 2008

Last updated

Jan 13, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)
• Kewa Pueblo Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santo Domingo Pueblo, NM
  • NPI 1467739888
  NPD (past)

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1780835504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87052",
            "telephone_number": "505-465-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#85 WEST HWY 22",
            "city": "SANTO DOMINGO",
            "state": "NM",
            "postal_code": "87052",
            "telephone_number": "505-465-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "ROGER",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-10",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NM",
            "license": "R54222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kewa Pueblo Health Corporation (Santo Domingo Health Center)
• Kewa Pueblo Health Corporation (Santo Domingo Health Center)
• Kewa Pueblo Health Corporation (Santo Domingo Health Center)
• Kewa Pueblo Health Corporation (Santo Domingo Health Center)
• Kewa Pueblo Health Corporation (Santo Domingo Health Center)
• Mary Teresa Omeddo, RN
• Tai Marie Paquin, LADAC
• John M Robertson, MD
• Samantha Nicole Torres, PHARM D.

• Health Service Clinic/Center in Santo Domingo, NM
• Providers in Santo Domingo, NM by specialty
• Health Service Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.