Misty Gorum

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2301 E 20TH St
Farmington, NM 87401-8905

Phone

(866) 273-2451

NPI assigned

Aug 19, 2024

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)

Not enrolled

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1952133753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 8TH ST STE C",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883105808",
            "telephone_number": "866-273-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E 20TH ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018905",
            "telephone_number": "866-273-2451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Las Cruces Ave Ste 1501",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880013488",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6565 Americas Pkwy NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871108172",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 8th St Ste C",
            "address_purpose": "LOCATION",
            "city": "Alamogordo",
            "state": "NM",
            "postal_code": "883105808",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1224 W 21st St",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "NM",
            "postal_code": "881014199",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1012 Marquez Pl Unit 106B",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875051833",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2705 S Alma School Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852864400",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 N Kansas St Ste 700",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799011444",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Artesia",
            "state": "NM",
            "postal_code": "882102168",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 N Canyon St",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "NM",
            "postal_code": "882205809",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 E College Blvd",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "NM",
            "postal_code": "882015158",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 W Aztec Ave",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873016666",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 N Hudson St",
            "address_purpose": "LOCATION",
            "city": "Silver City",
            "state": "NM",
            "postal_code": "880615435",
            "country_code": "US",
            "telephone_number": "866-273-2451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORUM",
        "first_name": "MISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Goodluck
• James P Goolsby, MD
• Faun Gordon
• Sandra L Gordon, RN
• Kaibah Gorman
• Gotherapy Solutions LLC
• Jan A Gotta, M.D.
• Grace Place for Women, Incorporated
• Tracie D Grace, FNP-C
• Derek Jay Graff, D.M.D.

• Behavior Technician in Farmington, NM
• Providers in Farmington, NM by specialty
• Behavior Technician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.