NPIMap

Organization Active NPI

Santa Fe Pediatric Cardiology, PC

  • Pediatric Cardiology Physician
  • Santa Fe, NM
National Provider Identifier
1891975561
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
1289503 Issued in NM
Legal business name
SANTA FE PEDIATRIC CARDIOLOGY, PC
Practice address
683 Harkle Rd Ste B
Santa Fe, NM 87505-4750
Phone
(505) 982-7661
Fax
(505) 988-5196
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Dr. C. Grant La Farge, M.D.
Title
President
Phone
(505) 982-7661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0202X 1289503 NM Primary

Addresses

Primary practice location

683 Harkle Rd Ste B
Santa Fe, NM 87505-4750

Mailing address

PO Box 4760
Santa Fe, NM 87502-4760
Phone (505) 982-7661

Other identifiers 1

IdentifierTypeStateIssuer
35006MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1891975561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4760",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875024760",
            "telephone_number": "505-982-7661",
            "fax_number": "505-988-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 HARKLE RD STE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054750",
            "telephone_number": "505-982-7661",
            "fax_number": "505-988-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA FE PEDIATRIC CARDIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "LA FARGE",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-982-7661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NM",
            "license": "1289503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35006",
            "state": "NM"
        }
    ],
    "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 Nov 9, 2007; 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.