Active NPI
Jazzmin Melissa Gonzalez
- Home Health Agency
- Santa Fe, NM
National Provider Identifier
1801301239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1700146314
- Practice address
- 2628 Ash St
Santa Fe, NM 87507-9293 - Phone
- (505) 603-9652
- NPI assigned
- Dec 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1700146314 | NM | Primary |
Addresses
Primary practice location
2628 Ash St
Santa Fe, NM 87507-9293
Mailing address
2628 Ash St
Santa Fe, NM 87507-9293
Phone (505) 603-9652
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1700146314 | NM | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512604800000",
"number": "1801301239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2628 ASH ST",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875079293",
"telephone_number": "505-603-9652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2628 ASH ST",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875079293",
"telephone_number": "505-603-9652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JAZZMIN",
"middle_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-07",
"last_updated": "2017-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NM",
"license": "1700146314",
"primary": true
}
],
"identifiers": [],
"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 Dec 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.