REGINA GANTT (NPI# 1396121505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
28 VALLE LINDO ROAD |
City | PERALTA |
State | NM |
Zip Code | 87042 |
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 |
Find all providers in zip 87042 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295191351 | Duke City Surgical Assisting LLC | Physician Assistant | 28 Valle Lindo Rd, Peralta, NM 87042-8230 | 2016-01-05 |
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 |
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.