NPIMap

Organization Active NPI

San Juan Obstetrics & Gynecology, LLC

  • Obstetrics & Gynecology Physician
  • Farmington, NM
National Provider Identifier
1942385448
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SAN JUAN OBSTETRICS & GYNECOLOGY, LLC
Practice address
814 W Maple St
Farmington, NM 87401-5631
Phone
(505) 325-9191
Fax
(505) 325-8585
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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

Authorized official

Name
Dr. Jerry Myron Karabin, MD
Title
Owner
Phone
(505) 325-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

814 W Maple St
Farmington, NM 87401-5631

Mailing address

814 W Maple St
Farmington, NM 87401-5631
Phone (505) 325-9191

Other identifiers 1

IdentifierTypeStateIssuer
00H5795MedicaidNM

National Provider Directory

National Provider Directory

Locations

814 W Maple St
Farmington, NM 87401
Phone (505) 325-9191

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1942385448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015631",
            "telephone_number": "505-325-9191",
            "fax_number": "505-325-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015631",
            "telephone_number": "505-325-9191",
            "fax_number": "505-325-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN OBSTETRICS & GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "KARABIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "MYRON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-325-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00H5795",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.

Verify at the official NPI Registry.