BEEWELL MEDICAL CENTER NPI 1033706924

NPI Information

  • NPI: 1033706924
  • Provider Name: BEEWELL MEDICAL CENTER
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • CLIA Number: 32D2210642
  • Address: 4201 CARLISLE BLVD NE # C
    ALBUQUERQUE, NM
    ZIP 87107
  • Phone: (505) 544-2366

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NPI Details

BEEWELL MEDICAL CENTER is a multi-specialty clinic center in Albuquerque, NM. BEEWELL MEDICAL CENTER NPI is 1033706924. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4201 CARLISLE BLVD NE # C
ALBUQUERQUE, NM
ZIP 87107-808
Phone: (505) 544-2366
Fax: (505) 581-6988

The provider's authorized official is Kontasha Shamika Wise .
The authorized official title is Cnp, Pmhnp-bc and has the following contact phone number (505) 554-8315.

The CLIA number assigned to this NPI record is 32D2210642 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/25/2020 and was last updated on 7/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthNo
2363LF0000XNurse PractitionerFamilyNo
3261QM1300XClinic/CenterMulti-SpecialtyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
106929753MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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