Mavrick James Lobe, DOM

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

446RX2 Issued in NM

Practice address

1348 Pacheco St
Suite 103
Santa Fe, NM 87505-4222

Phone

(505) 577-1588

NPI assigned

Apr 9, 2009

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 11, 2009.

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1235372012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 PACHECO ST",
            "address_2": "SUITE 103",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054222",
            "telephone_number": "505-577-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 PACHECO ST",
            "address_2": "SUITE 103",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054222",
            "telephone_number": "505-577-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBE",
        "first_name": "MAVRICK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NM",
            "license": "446RX2",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "446RX2",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NM",
            "license": "446RX2",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J Litzenberg, MD
• Liveability LLC
• Cynthia Livingston, MA LMHC
• Coby L Livingstone, OTR/L
• Edward Ray Lobaugh, CNP, CNS, APRN BC
• Noah Lobozzo
• Bonnie Lochner, RN
• Susanne Claire Lockford
• Janet A. Lockie Peukert, MST
• Meria L Loeks, LPCC

• All providers in Santa Fe, NM
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.