ADVANCED GASTROENTEROLOGY ASSOCIATES (NPI# 1184985475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184985475 |
| Entity Type | Organization |
| Organization Name | ADVANCED GASTROENTEROLOGY ASSOCIATES |
| Practice Address |
4801 N Butler Ave Suite 13102 Farmington NM 87401-6002 |
| Practice Telephone | 5054362906 |
| Practice Fax Number | 5054362197 |
| Mailing Telephone | 5054362906 |
| Mailing Fax Number | 5054362197 |
| Enumeration Date | 2012-06-03 |
| Last Update Date | 2013-04-21 |
| Authorized Official Name | MS. AUTUMN L ROBERTS (PRACTICE MANAGER) |
| Authorized Official Telephone | 5054362906 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 30177880 | 05 | |
| NM | AHCCCS | 792536 | 01 |
| NM | RR MCR | DT4411 | 01 |
| Street Address |
4801 N BUTLER AVE SUITE 13102 |
| City | FARMINGTON |
| State | NM |
| Zip Code | 87401-6002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536088 | Armando Lopez De Victoria | Internal Medicine | 4801 N Butler Ave, Suite 13102, Farmington, NM 87401-6002 | 2005-05-24 |
| 1164700571 | Tres Rios Anesthesiology LLC | Anesthesiology | 4801 N Butler Ave, Suite 5000, Farmington, NM 87401-6002 | 2011-08-02 |
| 1184850372 | Edmund Mcnally | Physician Assistant | 4801 N Butler Ave, Ste 8102, Farmington, NM 87401-6002 | 2009-06-02 |
| 1093928673 | Samuel C. Carpenter, Dpmpc | Podiatrist | 4801 N Butler Ave, Suite 9102, Farmington, NM 87401-6002 | 2007-05-08 |
| 1942365416 | Neurodiagnostics Ltd. | Psychiatry & Neurology | 4801 N Butler Ave, Ste. 8102, Farmington, NM 87401-0818 | 2006-12-26 |
| 1508920661 | Jean Graham | Specialist | 4801 N Butler Ave, Farmington, NM 87401-6002 | 2006-12-21 |
| 1568575314 | Michael Joseph Rutledge | Family Medicine | 4801 N Butler Ave, Suite 13101, Farmington, NM 87401-6002 | 2006-08-16 |
| 1265465884 | Uche N Obisike | Internal Medicine | 4801 N Butler Ave, Suite 8102, Farmington, NM 87401-0818 | 2006-07-08 |
| 1790720662 | Comprehensive Sleep Solutions, LLC | Clinic/Center | 4801 N Butler Ave, Ste 6102, Farmington, NM 87401-6002 | 2006-06-17 |
| 1740286780 | Denise Dorner | Podiatrist | 4801 N Butler Ave, Ste 14102, Farmington, NM 87401-6002 | 2005-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035192 | Jaylene Miller | Behavior Technician | 912 Fairgrounds Rd. Trl 36, Farmington, NM 87401 | 2020-08-28 |
| 1255940326 | John Andrew Martinez | Behavioral Analyst | 211 N Auburn, Farmington, NM 87401 | 2020-07-24 |
| 1598304990 | Chasitity Beulah Nez | Behavior Technician | 37 Rd 7101 #127, Farmington, NM 87401 | 2020-01-02 |
| 1205478575 | Micah Magee | Speech-Language Pathologist | Farmington High School, 2200 N. Sunset Ave, Farmington, NM 87401 | 2019-10-08 |
| 1831659754 | Lelilah Todacheene | Social Worker | 1204 Camina Real, Farmington, NM 87401 | 2019-03-25 |
| 1306323555 | Litany of Life | Counselor | 1010 Ridgeway Place, Farmington, NM 87401 | 2018-07-20 |
| 1093291213 | Brittany Bigham | Nurse Practitioner | 1001 W Broadway Ste E, Farmington, NM 87401 | 2018-07-11 |
| 1528556305 | Hairoun Home Health | Home Health | 1200 East 20th Street, Farmington, NM 87401 | 2018-04-26 |
| 1003338732 | Silver Tongue Speech & Voice, LLC | Clinic/Center | 3001 Northridge Dr Ste C, Farmington, NM 87401 | 2017-07-14 |
| 1902256621 | Capacity Builders Inc | Taxi | 418 W Broadway, Farmington, NM 87401 | 2016-06-14 |
| Find all providers in zip 87401 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275775058 | Donald E. Gullickson IIi | Internal Medicine | Uconn Health Center 263 Farmington Ave, Farmington, CT 06030-0001 | 2009-03-25 |
| 1508978511 | Francisco Colon | Internal Medicine | 940 W Pinon St, Farmington, NM 87401 | 2006-08-31 |
| 1508832429 | Eliezer M St Laurent | Internal Medicine | 23607 Farmington Rd, Farmington, MI 48336-3109 | 2006-02-28 |
| 1275536088 | Armando Lopez De Victoria | Internal Medicine | 4801 N Butler Ave, Suite 13102, Farmington, NM 87401-6002 | 2005-05-24 |
| 1639662901 | San Juan Regional Medical Center Inc | Internal Medicine | 940 W Pinon St, Farmington, NM 87401-5905 | 2018-06-12 |
| 1083977581 | Lucy Ann Salieb Shamberg | Internal Medicine | 263 Farmington Ave, Farmington, CT 06030-1845 | 2012-06-19 |
| 1043542459 | Eliezer Monge, M.d., P.C. | Internal Medicine | 23607 Farmington Rd, Farmington, MI 48336-3109 | 2010-02-10 |
| 1487896486 | Houman Rezaizadeh | Internal Medicine | 263 Farmington Ave, Farmington, CT 06030-0001 | 2009-04-06 |
| 1417199316 | Neil D Parikh | Internal Medicine | 21 South Rd, Suite 100, Farmington, CT 06032-2482 | 2009-03-24 |
| 1295917599 | State of Connecticut Health Center | Internal Medicine | 263 Farmington Ave, Gastroenterology Associates, Farmington, CT 06030-0001 | 2007-11-29 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 87401 |
Please comment or provide details below to improve the information on ADVANCED GASTROENTEROLOGY ASSOCIATES.
| 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.