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Export Provider Record NPI 1003065749
Martin Nicholas AnconaPH.D.
Active
NPI Number1003065749
NPI TypeNPI-1 Individual
SpecialtyPsychologist, Prescribing (Medical)
Provider Details
NPI1003065749
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2008-09-18
Last Updated2017-02-28
Mailing Address785 Anthony Drive
Anthony, NM 88021-9747
United States
Phone: (575) 882-5100
📍 View Map
Primary Practice Address320 Mccombs Rd Ste C
Chaparral, NM 88081-7937
United States
Phone: (575) 882-5100 | Fax: (575) 882-1151
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No103T00000X – PsychologistWAPY60201752
No103TC0700X – Psychologist, ClinicalNM1296
Yes103TP0016X – Psychologist, Prescribing (Medical)NM0040C
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About NPI 1003065749

Martin Nicholas Ancona PH.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1003065749. The primary specialty listed is Psychologist, Prescribing (Medical). The provider is located in Chaparral, NM. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-09-18. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1003065749?

NPI 1003065749 belongs to Martin Nicholas Ancona PH.D., a Psychologist, Prescribing (Medical) in Chaparral, NM. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1003065749 active?

The current status of NPI 1003065749 in the NPPES registry is Active. The record was last updated on 2017-02-28.

What specialty is NPI 1003065749?

NPI 1003065749 is classified under the taxonomy Psychologist, Prescribing (Medical). Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1003065749?

You can verify NPI 1003065749 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1003065749?

The primary practice address on file for NPI 1003065749 is 320 Mccombs Rd Ste C, Chaparral, NM 88081-7937. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1003065749 issued?

NPI 1003065749 was first issued (enumerated) on 2008-09-18. The NPPES record was last updated on 2017-02-28.

Practice Location Map

Martin Nicholas Ancona is located at 320 Mccombs Rd Ste C, Chaparral, NM. Use the map below to find directions or verify the practice location.

📍 320 Mccombs Rd Ste C, Chaparral, NM 88081-7937  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Martin Nicholas Ancona. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1003065749. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
PsychologistPY60201752WA
Psychologist, Clinical1296NM
Psychologist, Prescribing (Medical)0040CNM
Data Verified from CMS NPPES Last synced: 2026-05-31 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162