Individual provider Active NPI

Dorothy F Gault-McNemee, MD

  • Family Medicine Physician
  • Santa Teresa, NM
National Provider Identifier
1982656948
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NMMD81200 Issued in NM
Practice address
5290 McNutt Road
Santa Teresa, NM 88008-1590
Phone
(505) 589-1144
Fax
(505) 589-2008
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
Yes

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NMMD81200NMMDFamily Medicine Physician

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NMMD81200 NM Primary

Addresses

NPPES NPI Registry

Primary practice location

5290 McNutt Road
Santa Teresa, NM 88008-1590

Mailing address

PO Box 1590
Santa Teresa, NM 88008-1590
Phone (505) 589-1144

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
4536409OtherTXAETNA
NM001020OtherNMBLUE CROSS BLUE SHIELD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 4, 2008.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1982656948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1590",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880081590",
            "telephone_number": "505-589-1144",
            "fax_number": "505-589-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5290 MCNUTT ROAD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880081590",
            "telephone_number": "505-589-1144",
            "fax_number": "505-589-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULT-MCNEMEE",
        "first_name": "DOROTHY",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "NMMD81200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4536409",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NM001020",
            "state": "NM"
        }
    ],
    "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 Apr 4, 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.