Carla Bloedel-Clark, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

86180 Issued in NM

Practice address

5150 Journal Center Blvd NE
Albuquerque, NM 87109-5900

Phone

(505) 262-3219

Fax

(505) 262-3243

NPI assigned

Jul 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carla Bloedel Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optumcare Endoscopy Center New Mexico, LLC

  • Ambulatory Surgical Clinic/Center
  • Albuquerque, NM
  • NPI 1962685834
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1093748667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27829",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87125",
            "telephone_number": "505-232-1920",
            "fax_number": "505-727-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 JOURNAL CENTER BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095900",
            "telephone_number": "505-262-3219",
            "fax_number": "505-262-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOEDEL-CLARK",
        "first_name": "CARLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "86180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38828",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "BLOEDEL",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Vicki Bliss, RN
• Blissful Minds LLC
• Alaura Blizzard
• Danielle Rebecca Bloch
• Frederick H Blodgett, FNP-BC
• Dianna L Blom, LMHC
• Robyn Blomberg, RN
• Nicholas Louis Blonski, PT
• Bloom Bilingual Therapy LLC
• Bloom Trauma Therapy LLC

• Pediatrics Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.