JONATHAN REDD
NPI 1366918963
Nurse Practitioner - Family in Portales, NM

Active since October 22, 2018
1515 W FIR ST, PORTALES, NM 88130(575) 356-6695(575) 356-5948 Get Directions Write a Review

NPPES record last updated: October 22, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jonathan Redd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN REDD (NPI 1366918963) is an individual family provider in Portales, New Mexico, licensed in New Mexico (53956) and active in the NPI registry since October 2018.

NPPES Registry Identity

NPI1366918963
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJONATHAN REDD
Location Address1515 W FIR STPortales, NM 88130-5703
Mailing AddressPo Box 843Portales, NM 88130-0843 · (575) 356-6695 · Fax (575) 356-5948
Fax(575) 356-5948
Sole ProprietorNo
Enumeration DateOctober 22, 2018
NPI 1366918963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in NM · 53956
1515 W FIR ST, Portales, NM 88130

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
1515 W FIR ST
PORTALES, NM 88130
Nurse Practitioner (Family)
1515 W FIR ST
PORTALES, NM 88130
Nurse Practitioner (Family)
1515 W FIR ST
PORTALES, NM 88130
Nurse Practitioner (Psychiatric/Mental Health)
1515 W FIR ST
PORTALES, NM 88130
Local Education Agency (LEA)
1515 W FIR ST
PORTALES, NM 88130
Nurse Practitioner
1515 W FIR ST
PORTALES, NM 88130
Internal Medicine
1515 W FIR ST
PORTALES, NM 88130
Pediatrics (Pediatric Hematology-Oncology)
1515 W FIR ST
PORTALES, NM 88130

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Redd's NPI number?

The NPI number for Jonathan Redd is 1366918963. It was assigned to this individual provider in the NPPES registry on October 22, 2018.

Where is Jonathan Redd located?

Jonathan Redd practices at 1515 W Fir St, Portales, NM 88130. The listed phone number is (575) 356-6695.

What is Jonathan Redd's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Jonathan Redd was last updated on October 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.