NPIMap

Organization Active NPI

Phoenix Pediatrics LLC

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1124744909
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHOENIX PEDIATRICS LLC
Practice address
4233 Montgomery Blvd NE Ste 140
Albuquerque, NM 87109-6707
Phone
(505) 247-1471
NPI assigned
Oct 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Lena Chavez, FNPNPI 1770991994
Title
Owner
Phone
(505) 247-1471

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4233 Montgomery Blvd NE Ste 140
Albuquerque, NM 87109-6707

Mailing address

4233 Montgomery Blvd NE Ste 140
Albuquerque, NM 87109-6707
Phone (505) 247-1471

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL ChangeHealthcare Direct
CONNECT URL changehealthcare Direct

National Provider Directory

National Provider Directory

Locations

4233 Montgomery Blvd NE
Ste 140
Albuquerque, NM 87109
Phone (505) 247-1471

Practitioners & affiliated clinicians

Practitioners 2

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": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1124744909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4233 MONTGOMERY BLVD NE STE 140",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096707",
            "telephone_number": "505-247-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 MONTGOMERY BLVD NE STE 140",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096707",
            "telephone_number": "505-247-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "LENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-247-1471",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ChangeHealthcare",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4233 Montgomery Blvd NE Ste 140",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871096707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "changehealthcare",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4233 Montgomery Blvd NE Ste 140",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871096707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 13, 2022; 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.