Active NPI
Frederick Mosley, M.D.
- Exclusive Provider Organization
- Farmington, NM
National Provider Identifier
1174680987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exclusive Provider Organization
- License
- 97-111
- Practice address
- 2700 Farmington Ave
BLDG. F
Farmington, NM 87401-4559 - Phone
- (505) 325-1100
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | 97-111 | NM | Primary |
Addresses
Primary practice location
2700 Farmington Ave
BLDG. F
Farmington, NM 87401-4559
Mailing address
2700 Farmington Ave
BLDG. F
Farmington, NM 87401-4559
Phone (505) 325-1100
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97-111 | NM | MD | Exclusive Provider Organization |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174680987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 FARMINGTON AVE",
"address_2": "BLDG. F",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874014559",
"telephone_number": "505-325-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 FARMINGTON AVE",
"address_2": "BLDG. F",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874014559",
"telephone_number": "505-325-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSLEY",
"first_name": "FREDERICK",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "302F00000X",
"taxonomy_group": "",
"desc": "Exclusive Provider Organization",
"state": "NM",
"license": "97-111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.