Southwest Recovery and Wellness LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

SOUTHWEST RECOVERY AND WELLNESS LLC

Practice address

3874 Masthead St NE
Albuquerque, NM 87109-4479

Phone

(505) 896-9412

Fax

(505) 895-2505

NPI assigned

Mar 13, 2018

Organization subpart

No

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

Authorized official

Name

Robert D. Miller

Title

President

Phone

(323) 854-8587

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Thomas Joseph Whalen III, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Albuquerque, NM
  • NPI 1134120645
  NPD (past)

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520899200000",
    "number": "1043713415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 PINEHURST RD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871242219",
            "telephone_number": "323-854-8587",
            "fax_number": "505-896-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3874 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094479",
            "telephone_number": "505-896-9412",
            "fax_number": "505-895-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST RECOVERY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-854-8587"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568643146",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Family Medicine) Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Addiction Medicine (Family Medicine) Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.