Active NPI
Michael Padilla, RPH
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Ruidoso, NM
National Provider Identifier
1144791435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- PC00000306
- Practice address
- 211 Sudderth Dr
Ruidoso, NM 88345-6002 - Phone
- (575) 257-8264
- NPI assigned
- Dec 11, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP00008928 | NM | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PC00000306 | NM | Primary |
Addresses
Primary practice location
211 Sudderth Dr
Ruidoso, NM 88345-6002
Mailing address
211 Sudderth Dr
Ruidoso, NM 88345-6002
Phone (575) 257-8264
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP00008928 | NM | MD | Pharmacist |
| PC00000306 | NM | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Interoperability endpoints
- mpadilla124897@direct.phs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1144791435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 SUDDERTH DR",
"city": "RUIDOSO",
"state": "NM",
"postal_code": "883456002",
"telephone_number": "575-257-8264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 SUDDERTH DR",
"city": "RUIDOSO",
"state": "NM",
"postal_code": "883456002",
"telephone_number": "575-257-8264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADILLA",
"first_name": "MICHAEL",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-11",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "RP00008928",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "NM",
"license": "PC00000306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruidoso, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.