NPIMap

Organization Active NPI

Synergy Wellness Center LLC

  • Podiatric Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1154595825
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
307 Issued in NM
Legal business name
SYNERGY WELLNESS CENTER LLC
Practice address
4801 Lang Ave NE
Suite 110
Albuquerque, NM 87109-4474
Phone
(505) 892-9700
Fax
(505) 892-1210
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Authorized official

Name
Dr. Gloria Isabel Gerstner, DPM MSNPI 1235181199
Title
Ceo/Physician
Phone
(505) 892-9700

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
Podiatric Clinic/Center 261QP1100X 307 NM Primary

Addresses

Primary practice location

4801 Lang Ave NE
Suite 110
Albuquerque, NM 87109-4474

Mailing address

4801 Lang Ave NE
Suite 110
Albuquerque, NM 87109-4474
Phone (505) 892-9700

Other identifiers 1

IdentifierTypeStateIssuer
07835761MedicaidNM

Other names 1

  • High Desert Family Foot Care Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
High Desert Family Foot Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1154595825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 LANG AVE NE",
            "address_2": "SUITE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094474",
            "telephone_number": "505-892-9700",
            "fax_number": "505-892-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 LANG AVE NE",
            "address_2": "SUITE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094474",
            "telephone_number": "505-892-9700",
            "fax_number": "505-892-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "GERSTNER",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "ISABEL",
        "authorized_official_title_or_position": "CEO/PHYSICIAN",
        "authorized_official_telephone_number": "505-892-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM MS"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NM",
            "license": "307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07835761",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Desert Family Foot Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 May 6, 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.

Verify at the official NPI Registry.