Organization Active NPI

TWC Abq

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1124891650
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TWC ABQ
Practice address
6300 San Mateo Blvd NE Ste F2
Albuquerque, NM 87109-3536
Phone
(505) 818-1930
Fax
(505) 336-5399
NPI assigned
Nov 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Mark Anthony Cerna Jr.
Title
President
Phone
(505) 818-1930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6300 San Mateo Blvd NE Ste F2
Albuquerque, NM 87109-3536

Mailing address

6300 San Mateo Blvd NE Ste F2
Albuquerque, NM 87109-3536
Phone (505) 818-1930

Other names 1

  • The Wellness Company Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231208002362 NM Part B Supplier - Clinic/Group Practice 3375992860 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

6300 San Mateo Blvd NE
Ste F2
Albuquerque, NM 87109
Phone (505) 818-1930

6300 San Mateo Blvd NE
Albuquerque, NM 87109

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": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1124891650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 SAN MATEO BLVD NE STE F2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093536",
            "telephone_number": "505-818-1930",
            "fax_number": "505-336-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 SAN MATEO BLVD NE STE F2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093536",
            "telephone_number": "505-818-1930",
            "fax_number": "505-336-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWC ABQ",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "CERNA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-818-1930",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wellness Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.