Organization Active NPI

Sage Primary Care Clinic

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1043933054
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAGE PRIMARY CARE CLINIC
Practice address
7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314
Phone
(505) 884-1114
Fax
(505) 884-3004
NPI assigned
Sep 23, 2022
Organization subpart
Yes
Parent organization
SAGE NEUROSCIENCE CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Dr. Reuben Sutter, MD
Title
Ceo
Phone
(505) 884-1114

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RE0101X

Addresses

Primary practice location

7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314

Mailing address

7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314
Phone (505) 884-1114

National Provider Directory

National Provider Directory
Part of
Sage Neuroscience Center Inc

Locations

7850 Jefferson St NE
Ste 300
Albuquerque, NM 87109
Phone (505) 884-1114

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26558/brand/1/csg/41/fhir/r4

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1043933054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7850 JEFFERSON ST NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094314",
            "telephone_number": "505-884-1114",
            "fax_number": "505-884-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 JEFFERSON ST NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094314",
            "telephone_number": "505-884-1114",
            "fax_number": "505-884-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE PRIMARY CARE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAGE NEUROSCIENCE CENTER INC",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "SUTTER",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-884-1114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.