Kresta S Antillon

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD2018-0733 Issued in NM

Practice address

145 Don Pasqual Rd NW
Los Lunas, NM 87031-8841

Phone

(505) 865-4618

Fax

(505) 224-8727

NPI assigned

Apr 2, 2015

Last updated

Apr 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1861887192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC 09 5040",
            "address_2": "1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-994-5300",
            "fax_number": "505-344-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 DON PASQUAL RD NW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318841",
            "telephone_number": "505-865-4618",
            "fax_number": "505-224-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTILLON",
        "first_name": "KRESTA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2022-04-26",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2018-0733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Alvarez-English, LMSW
• Amable Therapies Inc.
• Dominique Ambriz, BMS
• Gabriel T. Anaya
• Celia Lynne Andrews, CNP
• Valerie M Apodaca
• Donna R Aragon I, BSW
• Elizabeth P Aragon
• Erin J Aragon, DPT
• Felicia Elena Aragon, PA-C

• Family Medicine Physician in Los Lunas, NM
• Providers in Los Lunas, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.