Individual provider Active NPI

Ronald Edward Dancy Jr., MSN, CNP, FNP-C

  • Family Nurse Practitioner
  • Crownpoint, NM
National Provider Identifier
1992081608
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
57859 Issued in NM
Practice address
2004 King Street
Unit 2
Crownpoint, NM 87313
Phone
(505) 360-6625
NPI assigned
Oct 26, 2011
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN124788 AZ
Family Nurse Practitioner 363LF0000X 57859 NM Primary

Addresses

Primary practice location

2004 King Street
Unit 2
Crownpoint, NM 87313

Mailing address

PO Box 327
Crownpoint, NM 87313-0327
Phone (505) 360-6625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230112000685 NM Practitioner - Nurse Practitioner 6103296959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehoboth McKinley Christian Health Care Services, Inc.Group PAC ID 1759293855, shared by 3 NPIs, 31 clinicians

Practice addresses (Care Compare)

1900 Red Rock Dr
Gallup, NM 87301-5682
Phone (505) 863-1820

1910 Red Rock Dr
Gallup, NM 87301-5682
Phone (505) 863-7136

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN124788AZMDRegistered Nurse
57859NMMDFamily Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1992081608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 327",
            "city": "CROWNPOINT",
            "state": "NM",
            "postal_code": "873130327",
            "telephone_number": "505-360-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 KING STREET",
            "address_2": "UNIT 2",
            "city": "CROWNPOINT",
            "state": "NM",
            "postal_code": "87313",
            "telephone_number": "505-360-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCY",
        "first_name": "RONALD",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "MSN, CNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN124788",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "57859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crownpoint, NM

Sources for this page

Verify at the official NPI Registry.