Taddy Healthcare Services

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A-1299-05 Issued in NM

Legal business name

TADDY HEALTHCARE SERVICES

Doing business as

Taddy Family Clinic

Practice address

615 W Mermod St
Carlsbad, NM 88220-4912

Phone

(575) 885-7714

Fax

(575) 885-7714

NPI assigned

Jan 21, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nii Tetteh Tsuru Addy, D.ONPI 1790855732

Title

President

Phone

(989) 482-1002

Specialties & licenses 2

Addresses

Other names 1

• TADDY FAMILY CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Nii Tetteh Tsuru Addy, D.O

  • Family Medicine Physician
  • Carlsbad, NM
  • NPI 1790855732
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1043541626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W MERMOD ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203513",
            "telephone_number": "575-885-7714",
            "fax_number": "575-885-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W MERMOD ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882204912",
            "telephone_number": "575-885-7714",
            "fax_number": "575-885-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TADDY HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "ADDY",
        "authorized_official_first_name": "NII TETTEH",
        "authorized_official_middle_name": "TSURU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-482-1002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A-1299-05",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NM",
            "license": "A-1299-05",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TADDY FAMILY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittany Ann Suniga, CSW
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• Lorri Swarney, COTA
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• Abebaw Dejene Tadesse, PHARMD
• Sara S Tanner
• Wendy L Tavarez
• Daniel Forest Taylor, M.D.
• Levi Taylor

• Family Medicine Physician in Carlsbad, NM
• Providers in Carlsbad, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.