Provider Type Icon

FAMILY MEDICINE PC NPI 1083802029


NPI Information

NPI: 1083802029
Provider Name: FAMILY MEDICINE PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 32D0976841

Address:
3825 EUBANK BLVD NE
ALBUQUERQUE, NM
ZIP 87111
Phone: (505) 292-8575
Get Directions

FAMILY MEDICINE PC is a family medicine in Albuquerque, NM. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAMILY MEDICINE PC NPI is 1083802029. The provider is registered as an organization entity type.

The provider's business location address is:

3825 EUBANK BLVD NE
ALBUQUERQUE, NM
ZIP 87111-559
Phone: (505) 292-8575
Fax: (505) 292-8409

The provider's authorized official is Stephanie Henderson .
The authorized official title is Practice Manager and has the following contact phone number (505) 292-8575.

The CLIA number assigned to this NPI record is 32D0976841 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/3/2007 and was last updated on 1/20/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary Care73-138NEW MEXICONo
2261QP2300XClinic/CenterPrimary CareNo
3207Q00000XFamily MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
144727MEDICAIDNEW 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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.