New Mexico Family Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP00453 Issued in NM

Legal business name

NEW MEXICO FAMILY CLINIC LLC

Practice address

3908 Juan Tabo Blvd NE
Albuquerque, NM 87111-3971

Phone

(505) 881-4012

Fax

(505) 881-4898

NPI assigned

Aug 16, 2012

Organization subpart

No

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

Authorized official

Name

Carla Franco, FNP-BCNPI 1942233507

Title

Registered Agent

Phone

(505) 881-4012

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carla K Franco, CNP

  • Family Nurse Practitioner
  • Albuquerque, NM
  • NPI 1942233507
  Medicare reassignment NPD Authorized official
• Samantha Marie Pacheco

  • Family Nurse Practitioner
  • Albuquerque, NM
  • NPI 1043841802
  NPD

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1023366374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113971",
            "telephone_number": "505-881-4012",
            "fax_number": "505-881-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113971",
            "telephone_number": "505-881-4012",
            "fax_number": "505-881-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "FRANCO",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "505-881-4012",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP00453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51107066",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.