Active NPI
Robert H Wilson, M.D.
- Sports Medicine (Family Medicine) Physician
- Albuquerque, NM
National Provider Identifier
1154309698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 92-377
- Practice address
- 201 Cedar St SE
Suite 6600
Albuquerque, NM 87106-4917 - Phone
- (505) 724-4300
- Fax
- (505) 724-4384
- NPI assigned
- Jan 5, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 92-377 | NM | Primary |
Addresses
Primary practice location
201 Cedar St SE
Suite 6600
Albuquerque, NM 87106-4917
Mailing address
201 Cedar St SE
Suite 6600
Albuquerque, NM 87106-4917
Phone (505) 724-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E6907 | Medicaid | NM |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Mexico Orthopaedic Associates PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Albuquerque, NM
- NPI 1407898299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1154309698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 CEDAR ST SE",
"address_2": "SUITE 6600",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064917",
"telephone_number": "505-724-4300",
"fax_number": "505-724-4384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 CEDAR ST SE",
"address_2": "SUITE 6600",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064917",
"telephone_number": "505-724-4300",
"fax_number": "505-724-4384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ROBERT",
"middle_name": "H",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-05",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "NM",
"license": "92-377",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000E6907",
"state": "NM"
}
],
"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 Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.