Active NPI
Tania Hurlbutt, MD
- Pediatrics Physician
- Crownpoint, NM
National Provider Identifier
1790710861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 9901420
- Practice address
- Junction Navajo Route 9, Highway 371
Crownpoint, NM 87313-0358 - Phone
- (505) 786-5291
- Fax
- (505) 786-6440
- NPI assigned
- Jul 11, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9901420 | NC | Primary |
Addresses
Primary practice location
Junction Navajo Route 9, Highway 371
Crownpoint, NM 87313-0358
Mailing address
PO Box 358
Crownpoint, NM 87313-0358
Phone (505) 786-5291
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G3466 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9901420 | NC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790710861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 358",
"city": "CROWNPOINT",
"state": "NM",
"postal_code": "873130358",
"telephone_number": "505-786-5291",
"fax_number": "505-786-6440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JUNCTION NAVAJO ROUTE 9, HIGHWAY 371",
"city": "CROWNPOINT",
"state": "NM",
"postal_code": "873130358",
"telephone_number": "505-786-5291",
"fax_number": "505-786-6440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURLBUTT",
"first_name": "TANIA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "9901420",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G3466",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crownpoint, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.