Individual provider Active NPI

Glenn M Rosendale

  • Case Manager/Care Coordinator
  • Albuquerque, NM
National Provider Identifier
1073847273
Registry record updated Sep 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
7900 Bell Ave SE
Apt 15
Albuquerque, NM 87108-4123
Phone
(505) 254-0320
Fax
(505) 254-8119
NPI assigned
Sep 22, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

7900 Bell Ave SE
Apt 15
Albuquerque, NM 87108-4123

Mailing address

7900 Bell Ave SE
Apt 15
Albuquerque, NM 87108-4123
Phone (505) 254-0320

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

NPI Registry JSON

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253577600000",
    "number": "1073847273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 BELL AVE SE",
            "address_2": "APT 15",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084123",
            "telephone_number": "505-254-0320",
            "fax_number": "505-254-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 BELL AVE SE",
            "address_2": "APT 15",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084123",
            "telephone_number": "505-254-0320",
            "fax_number": "505-254-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENDALE",
        "first_name": "GLENN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 22, 2009; 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.