KATHLEEN MEZOFF (NPI# 1942272208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942272208 |
| Entity Type | Individual |
| Full Name | KATHLEEN MEZOFF |
| Credential | MD |
| Practice Address |
2111 College Dr Gallup NM 87301-5600 |
| Mailing Address |
1901 Redrock Dr Pfs Dept Gallup NM 87301-5683 |
| Practice Telephone | 5058631820 |
| Mailing Telephone | 5058637000 |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
80-68 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CHAMPUS | 85031326887301A131 | 01 | |
| NM | MOLINA | PROVP14495 | 01 |
| AZ | 239922 | 05 | |
| NM | BCBS | NM001861 | 01 |
| NM | LOVELACE HEALTH/SALUD | 10002105 | 01 |
| NM | 13656 | 05 |
| Street Address |
2111 COLLEGE DR |
| City | GALLUP |
| State | NM |
| Zip Code | 87301-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538147640 | Christopher Gonzaga | Internal Medicine | 2111 College Dr, Rehoboth Mckinley Christian Health Care Services, Gallup, NM 87301-5600 | 2006-01-09 |
| 1558994301 | Sarah Sharpton | Health Educator | 2111 College Dr, Gallup, NM 87301-5600 | 2020-02-20 |
| 1538635610 | Scott Paden | Dietitian, Registered | 2111 College Dr, Gallup, NM 87301-5600 | 2018-10-16 |
| 1174007223 | Jose Aruiza | Nurse Practitioner | 2111 College Dr, Gallup, NM 87301-5600 | 2018-09-24 |
| 1477077345 | Charisse Buchanan | Nurse Practitioner | 2111 College Dr, Gallup, NM 87301-5600 | 2017-08-01 |
| 1780123935 | Daisy Arsenault | Dietitian, Registered | 2111 College Dr, Gallup, NM 87301-5600 | 2017-02-21 |
| 1306215926 | Antonia Hernandez | Registered Nurse | 2111 College Dr, Gallup, NM 87301-5600 | 2015-09-24 |
| 1922242965 | Melinda Kathryn Rogers | Pediatrics | 2111 College Dr, Gallup, NM 87301-5600 | 2009-04-21 |
| 1487844791 | Nicolas Lee Peters | Pediatrics | 2111 College Dr, Gallup, NM 87301-5600 | 2007-08-01 |
| 1689779860 | Rehoboth Mckinley Christian Health Care Services, Inc | Pediatrics | 2111 College Dr, Gallup, NM 87301-5600 | 2006-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966141 | Karen Marie Acuesta Arboleda | Registered Nurse | 516 E Nizhoni Bld., Gallup, NM 87301 | 2019-11-13 |
| 1811453707 | Kelly Dahn | Respiratory Therapist, Certified | 516 E Hizhoni Blvd, Gallup, NM 87301 | 2019-02-15 |
| 1417411232 | Frances Griego | Registered Nurse | 28b Alma Drive, Gallup, NM 87301 | 2019-01-25 |
| 1891267605 | Hozho Academy | Occupational Therapist | 306 Nm-564, Gallup, NM 87301 | 2018-12-19 |
| 1922514686 | Jjdac, LLC | Ambulance | 208 W Maloney Ave, Gallup, NM 87301 | 2017-12-18 |
| 1508382698 | Katherine L Kuehl | Pharmacist | Walgreens 1870 E Historic Highway 66, Galliup, NM 87301 | 2017-08-21 |
| 1497285001 | Jessica Kate Savant | Registered Nurse | 516 E Nazhoni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1770013385 | Nicole Aline Pavy | Registered Nurse | 516 E. Nizhioni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1730612276 | Camie Renee Nelson | Contractor | 121 Bishop Drive, Gallup, NM 87301 | 2017-04-11 |
| 1508216227 | Marriah Silversmith | Technician, Other | 3426 Blue Hill Ave, Gallup, NM 87301 | 2016-06-14 |
| Find all providers in zip 87301 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831628551 | Roberto Talamantes Md Pa | Pediatrics | 2903 Hillrise Dr, Las Cruces, NM 88011-4701 | 2017-06-06 |
| 1518973189 | Stewart Duban | Pediatrics | 3rd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-08-01 |
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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.