Djaa Tlhenai Medicine Lodge

Primary specialty

SpecialistTaxonomy code 174400000X

License

12-00116271 Issued in NM

Legal business name

DJAA TLHENAI MEDICINE LODGE

Practice address

111 Carlisle Blvd SE
Albuquerque, NM 87106-1427

Phone

(505) 819-3403

NPI assigned

Nov 7, 2013

Last updated

Nov 7, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

LI PA HENNE TRIBEAs reported in NPPES

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

Authorized official

Name

Oatzinu Sheelakee, IAMP

Title

Founder

Phone

(505) 819-3403

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1164851382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 4682",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87196",
            "telephone_number": "505-819-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CARLISLE BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871061427",
            "telephone_number": "505-819-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DJAA TLHENAI MEDICINE LODGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LI PA HENNE TRIBE",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "SHEELAKEE",
        "authorized_official_first_name": "OATZINU",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "505-819-3403",
        "authorized_official_credential": "IAMP"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "12-00116271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.