Individual provider Active NPI

Dana G Wilmot, RN

  • Registered Nurse
  • Albuquerque, NM
National Provider Identifier
1053638007
Registry record updated Apr 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R45523 Issued in NM
Practice address
2600 Marble Ave NE
Albuquerque, NM 87106-2058
Phone
(505) 999-6610
NPI assigned
Apr 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R45523 NM Primary

Addresses

Primary practice location

2600 Marble Ave NE
Albuquerque, NM 87106-2058

Mailing address

1532 Reynosa Loop SE
Rio Rancho, NM 87124-8751
Phone (505) 999-6610

Other identifiers 1

IdentifierTypeStateIssuer
R45523OtherNMNEW MEXICO BOARD OF NURSING

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R45523NMMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272585600000",
    "number": "1053638007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 REYNOSA LOOP SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871248751",
            "telephone_number": "505-999-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MARBLE AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062058",
            "telephone_number": "505-999-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMOT",
        "first_name": "DANA",
        "middle_name": "G",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2010-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R45523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO BOARD OF NURSING",
            "identifier": "R45523",
            "state": "NM"
        }
    ],
    "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 Apr 30, 2010; 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.