Active NPI
Candace Poppas Leas, CNP
- Acute Care Nurse Practitioner
- Albuquerque, NM
National Provider Identifier
1194748491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- R33049
- Practice address
- 933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374 - Phone
- (505) 272-3120
- Fax
- (505) 272-8060
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | R33049 | NM | Primary |
Addresses
Primary practice location
933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Mailing address
933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A2808 | 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
- Certified Nurse Practitioner, Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317081600000",
"number": "1194748491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 BRADBURY DR SE",
"address_2": "SUITE 2222",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064374",
"telephone_number": "505-272-3120",
"fax_number": "505-272-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 BRADBURY DR SE",
"address_2": "SUITE 2222",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064374",
"telephone_number": "505-272-3120",
"fax_number": "505-272-8060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAS",
"first_name": "CANDACE",
"middle_name": "POPPAS",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2011-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "NM",
"license": "R33049",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A2808",
"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 Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.