Active NPI
C.G. Elliott Foucar, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Albuquerque, NM
National Provider Identifier
1104156033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 74-29
- Practice address
- 14029 Wind Mountain Rd NE
Albuquerque, NM 87112-6564 - Phone
- (505) 275-1395
- Fax
- (595) 275-1395
- NPI assigned
- Dec 24, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology Physician | 207ND0900X | 74-29 | NM | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 74-29 | NM | Primary |
Addresses
Primary practice location
14029 Wind Mountain Rd NE
Albuquerque, NM 87112-6564
Mailing address
14029 Wind Mountain Rd NE
Albuquerque, NM 87112-6564
Phone (505) 275-1395
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74-29 | NM | MD | Dermatopathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261612800000",
"number": "1104156033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14029 WIND MOUNTAIN RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871126564",
"telephone_number": "505-275-1395",
"fax_number": "595-275-1395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14029 WIND MOUNTAIN RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871126564",
"telephone_number": "505-275-1395",
"fax_number": "595-275-1395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUCAR",
"first_name": "C.G.",
"middle_name": "ELLIOTT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-24",
"last_updated": "2009-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "NM",
"license": "74-29",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NM",
"license": "74-29",
"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 Dec 24, 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.