Individual provider Active NPI

Juanita Duarte

  • Speech-Language Pathologist
  • Santa Teresa, NM
National Provider Identifier
1891940425
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
C-4437 Issued in NM
Practice address
4950 McNutt Rd
Santa Teresa, NM 88008-9621
Phone
(575) 882-6200
NPI assigned
Nov 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X C-4437 NM Primary

Addresses

Primary practice location

4950 McNutt Rd
Santa Teresa, NM 88008-9621

Mailing address

4950 McNutt Rd
Santa Teresa, NM 88008-9621

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

LicenseStateTypeSpecialty
C-4437NMMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1891940425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 MCNUTT RD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 MCNUTT RD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089621",
            "telephone_number": "575-882-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUARTE",
        "first_name": "JUANITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "C-4437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Teresa, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; 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.