Individual provider Active NPI

Henry Huson Middleton III, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Albuquerque, NM
National Provider Identifier
1063419547
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
78-226 Issued in NM
Practice address
8208 Louisiana Blvd NE
Ste C
Albuquerque, NM 87113-1757
Phone
(505) 858-1222
Fax
(505) 858-1224
NPI assigned
Jun 30, 2005
Last updated
Aug 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 78-226 NM Primary

Addresses

Primary practice location

8208 Louisiana Blvd NE
Ste C
Albuquerque, NM 87113-1757

Mailing address

1524 Eubank Blvd NE
Ste 6
Albuquerque, NM 87112-4160
Phone (760) 449-4351

Other identifiers 1

IdentifierTypeStateIssuer
06064MedicaidNM

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1063419547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 EUBANK BLVD NE",
            "address_2": "STE 6",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871124160",
            "telephone_number": "760-449-4351",
            "fax_number": "866-530-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8208 LOUISIANA BLVD NE",
            "address_2": "STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131757",
            "telephone_number": "505-858-1222",
            "fax_number": "505-858-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "HENRY",
        "middle_name": "HUSON",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NM",
            "license": "78-226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06064",
            "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 Aug 21, 2019; 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.