CHARLES NMI VANDIVER (NPI# 1306861166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306861166 |
| Entity Type | Individual |
| Full Name | CHARLES NMI VANDIVER |
| Credential | R.PH., PH.C. |
| Practice Address |
1422 Paseo De Peralta Santa Fe NM 87501-4391 |
| Mailing Address |
Po Box 307 11 Preston Trail Angel Fire NM 87710-0307 |
| Practice Telephone | 5052893291 |
| Practice Fax Number | 5052893648 |
| Mailing Telephone | 5053772548 |
| Mailing Fax Number | 5053772548 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
PC00000033 | NM | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | NM CONTROLLED SUBST. NUM | CS00021140 | 01 |
| NM | DEA REGISTRATION NUMBER | MV0382755 | 01 |
| NM | PHARMACIST CLINICIAN NUM | PC00000033 | 01 |
| NM | REGISTERED PHARMACIST # | 4458 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508884628 | Charles Edwin Vandiver | Dentist | 660 7th St., Meeker, CO 81641-1008 | 2006-07-17 |
| 1598809865 | Charles M Vandiver | Counselor | 424 S Oakes St, San Angelo, TX 76903-5944 | 2007-02-19 |
| Street Address |
1422 PASEO DE PERALTA |
| City | SANTA FE |
| State | NM |
| Zip Code | 87501-4391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518910553 | Presbyterian Medical Services | Dentist | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2006-05-19 |
| 1104453828 | Deborah Marie Correnti | Registered Nurse | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2020-03-24 |
| 1922554054 | Dolce Reyes | Nurse Practitioner | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2016-08-29 |
| 1699144998 | Miles Lessen | Nurse Practitioner | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2015-09-17 |
| 1275860942 | Melba Regina Sanchez | Social Worker | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2009-11-17 |
| 1548493349 | Iisha Marie Toombs | Social Worker | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2009-08-26 |
| 1487892246 | Christina Kay Pound | Pharmacist | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2009-01-30 |
| 1275703118 | Gina Brigette Perez-baron | Family Medicine | 1422 Paseo De Peralta, Questa Health Center, Santa Fe, NM 87501-4391 | 2008-03-06 |
| 1316123482 | Joanna Gawne Magee | Social Worker | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2008-01-18 |
| 1043378060 | Lawrence Lyons | Family Medicine | 1422 Paseo De Peralta, Santa Fe, NM 87501-4391 | 2006-12-04 |
| Find all providers in the same location | ||||
| 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 | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508003898 | Frances E. Lovett | Pharmacist | 1421 Luisa St, Santa Fe, NM 87505-4073 | 2009-01-08 |
| 1073783460 | Robert Shirley | Pharmacist | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2008-03-03 |
| 1790992873 | William R. Reeves | Pharmacist | 455 Saint Michaels Dr, St. Vincent Hospital, Anticoagulation Management Servic, Santa Fe, NM 87505-7601 | 2007-05-17 |
| 1922094408 | Kyle Vance Sheffer | Pharmacist | 1700 Cerrillos Rd, Santa Fe, NM 87505-3554 | 2005-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033751755 | Adam Michael Sandoval | Pharmacist | 1115 N Riverside Dr # Der, Espanola, NM 87532-2802 | 2019-10-14 |
| 1750798575 | Rebecca Van Vleck | Pharmacist | 12501 Monarch Dr Ne, Albuquerque, NM 87123-1542 | 2014-07-14 |
| 1962751834 | James J Nawarskas | Pharmacist | 1101 Medical Arts, N.e., Bldg. 4 - Suite A, Albuquerque, NM 87106 | 2012-09-06 |
| 1083920532 | Darlington Friday Egbu | Pharmacist | Junction of Route 371 & Route 9, Crownpoint Healthcare Facility, Crownpoint, NM 87313 | 2010-08-23 |
| 1750614178 | Paul D Gailard | Pharmacist | 5019 San Adan Ave Nw, Albuquerque, NM 87120-1835 | 2009-09-16 |
| 1366612830 | Lisa Ann Cohn | Pharmacist | Interstate 40 @ Exit 102, Acl Hospital Pharmacy Dept, San Fidel, NM 87049 | 2008-03-11 |
| 1346422458 | David B Denoyer | Pharmacist | 7417 Staghorn Dr Nw, Albuquerque, NM 87120-3019 | 2007-11-30 |
| 1891919858 | Renee-claude Mercier | Pharmacist | University of New Mexico College of Pharmacy, Msc09 5360 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2007-04-12 |
| 1730200171 | Carol Rose Cummins | Pharmacist | Interstate 40 Exit 102, San Fidel, NM 87049 | 2007-04-03 |
| 1316066244 | Jill Sanders | Pharmacist | 125 Bia Route, Pine Hill Health Center, Pine Hill, NM 87357 | 2007-03-29 |
| 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.