REGINA GANTT


Address: 28 Valle Lindo Road, Peralta, NM 87042
Phone: 5052805326

REGINA GANTT (NPI# 1396121505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396121505
Entity Type Individual
Full Name REGINA GANTT
Credential CSFA
Practice Address 28 Valle Lindo Road
Peralta
NM 87042
Practice Telephone 5052805326
Practice Fax Number 5058485008
Mailing Telephone 5052805326
Mailing Fax Number 5058485008
Enumeration Date 2015-08-11
Last Update Date 2016-01-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 28 VALLE LINDO ROAD
City PERALTA
State NM
Zip Code 87042

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316451354 Courtney Emily Escalera Registered Nurse 3645 Nm-47, Peralta, NM 87042 2017-11-29
1396951877 Jennifer Lynn Jarpe Specialist 20 Don Pedro Rd, Peralta, NM 87042 2007-05-14
1447729397 Audrey Deniece Dumas Registered Nurse 3645 Nm-47, Peralta, NM 87042 2018-11-21
1497201859 Marco Ortiz Technician, Other 46 Monica Rd, Peralta, NM 87042-5171 2016-08-26
1295191351 Duke City Surgical Assisting LLC Physician Assistant 28 Valle Lindo Rd, Peralta, NM 87042-8230 2016-01-05
1396082392 Emily Ferreira Acupuncturist 2 Zamora Ln, Peralta, NM 87042-8400 2013-01-10
1083252928 Diana Kristine Keith Dietitian, Registered 11 Frampton Pl, Peralta, NM 87042-8405 2019-12-11
1427004449 Joe's Pharmacy L.L.C. Pharmacy 3646 Highway 47, Peralta, NM 87042-8468 2006-05-25
1629516729 Starbright Pediatric Home Health Home Health 10 Bronco Ct, Peralta, NM 87042-8508 2017-02-08
1114532637 Diana Alvarez Behavior Technician 16 Samantha Ct, Peralta, NM 87042-8800 2020-09-11
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295191351 Duke City Surgical Assisting LLC Physician Assistant 28 Valle Lindo Rd, Peralta, NM 87042-8230 2016-01-05

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1699272633 Walter Barney Physician Assistant 708 Luna Vis, Santa Fe, NM 87506-2003 2018-04-06
1225564800 Mariam H Bokolishvili Physician Assistant 1511 W Alameda St, Santa Fe, NM 87501-1746 2017-05-03
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
1508161936 New Mexico Surgical Assisting, Inc Physician Assistant 1505 Kachina Ridge Dr, Santa Fe, NM 87507-5172 2011-01-15
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
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Competitor

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City PERALTA
Zip Code 87042

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Dataset Information

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.

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