Active NPI
Mattie Firlit
- Registered Dietitian
- Albuquerque, NM
National Provider Identifier
1114533239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1392
- Practice address
- 601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619 - Phone
- (505) 727-8000
- NPI assigned
- Sep 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1392 | NM | Primary |
Addresses
Primary practice location
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Mailing address
5320 San Mateo Blvd NE Apt C29
Albuquerque, NM 87109-6254
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1392 | NM | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1114533239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5320 SAN MATEO BLVD NE APT C29",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871096254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 DR MARTIN LUTHER KING JR AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023619",
"telephone_number": "505-727-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIRLIT",
"first_name": "MATTIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-23",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NM",
"license": "1392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
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- Fireweed Therapy LLC
- First Choice Community Healthcare, Inc.
- First Choice Community Healthcare, Inc.
- First Choice Community Healthcare, Inc.
- First Choice Community Healthcare, Inc.
- First Choice Community Healthcare, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.