Individual provider Active NPI

Mark Woodward, NREMT-BASIC

  • Basic Emergency Medical Technician
  • Santa Fe, NM
National Provider Identifier
1013630755
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
E3672633 Issued in NM
Practice address
2052 Galisteo St
Santa Fe, NM 87505-2100
Phone
(505) 819-3419
NPI assigned
Sep 19, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X E3672633 NM Primary

Addresses

Primary practice location

2052 Galisteo St
Santa Fe, NM 87505-2100

Mailing address

2052 Galisteo St
Santa Fe, NM 87505-2100
Phone (505) 819-3419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E3672633NMMDBasic Emergency Medical Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1013630755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2052 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052100",
            "telephone_number": "505-819-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2052 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052100",
            "telephone_number": "505-819-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "MARK",
        "credential": "NREMT-BASIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NM",
            "license": "E3672633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.