MARIAM H BOKOLISHVILI (NPI# 1225564800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225564800 |
Entity Type | Individual |
Full Name | MARIAM H BOKOLISHVILI |
Other Name | MARIAM BOKOLISHVILI |
Credential | S.A. |
Practice Address |
1511 W Alameda St Santa Fe NM 87501-1746 |
Practice Telephone | 5054593988 |
Mailing Telephone | 5054593988 |
Enumeration Date | 2017-05-03 |
Last Update Date | 2018-05-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
15-489 | Physician Assistants & Advanced Practice Nursing Providers | |
N | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
15-489 | Technologists, Technicians & Other Technical Service Providers |
Street Address |
1511 W ALAMEDA ST |
City | SANTA FE |
State | NM |
Zip Code | 87501-1746 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841775327 | Rasanjana Bhandari | Behavior Technician | 1505 Paseo De Conquistadora, Santa Fe, NM 87501 | 2018-10-01 |
1497102172 | New Mexico Neurodiagnostics, LLC | Clinic/Center | 150 Washington Ave., Ste. #201-220, Office 224, Santa Fe, NM 87501 | 2016-05-23 |
1831557891 | Jane Berger | Social Worker | 300 Griffin St Ste 213, Santa Fe, NM 87501 | 2016-02-05 |
1316325061 | Serenity Wellness Center of Santa Fe, LLC | Counselor | 343 E Palace Ave, Santa Fe, NM 87501 | 2015-05-14 |
1902209497 | Mdlive Medical Group Nm LLC | Counselor | 123 Marcy Street, Santa Fe, NM 87501 | 2014-09-29 |
1396154183 | Julie Price | Counselor | 1 Montoya Cir, Santa Fe, NM 87501 | 2014-08-06 |
1053609487 | Michael Shawn Haner | Acupuncturist | 909 Early St., Santa Fe, NM 87501 | 2011-07-19 |
1396045316 | Dana Moore | Counselor | 950 Canyon Rd., Santa Fe, NM 87501 | 2010-10-25 |
1720394232 | Susan Nelsen | Social Worker | 118 Huddleson St, Santa Fe, NM 87501 | 2010-08-20 |
1033434543 | Anthony R Moya | Social Worker | 501 Franklin Ave Ofc 6, Santa Fe, NM 87501 | 2010-03-29 |
Find all providers in zip 87501 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699272633 | Walter Barney | Physician Assistant | 708 Luna Vis, Santa Fe, NM 87506-2003 | 2018-04-06 |
1508161936 | New Mexico Surgical Assisting, Inc | Physician Assistant | 1505 Kachina Ridge Dr, Santa Fe, NM 87507-5172 | 2011-01-15 |
1861049918 | Waltor Surgical Assisting | Physician Assistant | 708 Luna Vista, Santa Fe, NM 87506 | 2019-08-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295191351 | Duke City Surgical Assisting LLC | Physician Assistant | 28 Valle Lindo Rd, Peralta, NM 87042-8230 | 2016-01-05 |
1396121505 | Regina Gantt | Physician Assistant | 28 Valle Lindo Road, Peralta, NM 87042 | 2015-08-11 |
1013398072 | Lauren Soules | Physician Assistant | 3615 Highway 528 Nw, Albuquerque, NM 87114-8919 | 2015-06-16 |
1447666508 | Audrey Rich | Physician Assistant | 201 Cedar Ave, Albuquerque, NM 87106 | 2014-07-09 |
1104178813 | Adam M Newman | Physician Assistant | University of New Mexico Hospital Department, Msc 10 5610, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2012-10-04 |
1255682944 | Armstrong Medical LLC | Physician Assistant | 13170 Central Ave Se, Suite B 345, Albuquerque, NM 87123 | 2012-09-21 |
1033494992 | Sandra Seward | Physician Assistant | 11 Calle Pinon, Placitas, NM 87043-9316 | 2011-10-11 |
1033386420 | Patrick Keenan Shanley | Physician Assistant | 1219 Gusdorf Rd Ste A, Taos, NM 87571-6499 | 2008-05-14 |
1982818860 | Kristen Marron Bushnell | Physician Assistant | Pmg At 8300 Constitution - General Surgery, 8300 Constitution Ave Ne, Albuquerque, NM 87110 | 2007-05-09 |
1629092457 | David A Mcculloch | Physician Assistant | 1501 San Pedro, Se, Va Medical Center, Albuquerque, NM 87108 | 2006-07-26 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.