Organization Active NPI

Daniel Junck LLC

  • Medical Specialty Clinic/Center
  • Santa Fe, NM
National Provider Identifier
1902000680
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
2005-0474 Issued in NM
Legal business name
DANIEL JUNCK LLC
Practice address
223 N Guadalupe St
Suite 466
Santa Fe, NM 87501-1868
Phone
(505) 670-6549
Fax
(505) 830-4803
NPI assigned
Jun 14, 2007
Last updated
Dec 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Dr. Daniel Lee Junck, MD
Title
Physician, Owner
Phone
(505) 670-6549

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 2005-0474 NM Primary

Addresses

Primary practice location

223 N Guadalupe St
Suite 466
Santa Fe, NM 87501-1868

Mailing address

223 N Guadalupe St
Suite 466
Santa Fe, NM 87501-1868
Phone (505) 670-6549

Other identifiers 1

IdentifierTypeStateIssuer
46257268MedicaidNM

National Provider Directory

National Provider Directory

Locations

609 Broadway Blvd NE
Ste 205
Albuquerque, NM 87102

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1902000680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N GUADALUPE ST",
            "address_2": "SUITE 466",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011868",
            "telephone_number": "505-670-6549",
            "fax_number": "505-830-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N GUADALUPE ST",
            "address_2": "SUITE 466",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011868",
            "telephone_number": "505-670-6549",
            "fax_number": "505-830-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL JUNCK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "JUNCK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHYSICIAN, OWNER",
        "authorized_official_telephone_number": "505-670-6549",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NM",
            "license": "2005-0474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46257268",
            "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 Dec 29, 2011; 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.