Organization Active NPI

Blue Sky Wellness

  • Community/Behavioral Health Agency
  • Albuquerque, NM
National Provider Identifier
1093437600
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BLUE SKY WELLNESS
Practice address
4001 Juan Tabo Blvd NE
Albuquerque, NM 87111-3955
Phone
(214) 462-0442
NPI assigned
Sep 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Quinton MiddletonNPI 1386012912
Title
Owner
Phone
(505) 633-7898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4001 Juan Tabo Blvd NE
Albuquerque, NM 87111-3955

Mailing address

4001 Juan Tabo Blvd NE
Albuquerque, NM 87111-3955
Phone (505) 633-7898

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2275791Blue Sky Wellness4001 Juan Tabo, Albuquerque, NM 87111Certificate of waiverJan 26, 2027

National Provider Directory

National Provider Directory

Locations

4001 Juan Tabo Blvd NE
Albuquerque, NM 87111
Phone (214) 462-0442

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1093437600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113955",
            "telephone_number": "505-633-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113955",
            "telephone_number": "214-462-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "QUINTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-633-7898"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "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 Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.