Active NPI
Johnnie Lanier
- Peer Specialist
- Albuquerque, NM
National Provider Identifier
1245000496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 1122
- Practice address
- 11401 Menaul Blvd NW
Albuquerque, NM 87112 - Phone
- (505) 526-3649
- Fax
- (866) 598-3722
- NPI assigned
- Jan 8, 2024
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 1122 | NM | Primary |
Addresses
Primary practice location
11401 Menaul Blvd NW
Albuquerque, NM 87112
Mailing address
300 Menaul Blvd NW Ste a
Albuquerque, NM 87107-1347
Phone (505) 526-3649
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1122 | NM | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704672000000",
"number": "1245000496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MENAUL BLVD NW STE A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871071347",
"telephone_number": "505-526-3649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11401 MENAUL BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87112",
"telephone_number": "505-526-3649",
"fax_number": "866-598-3722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANIER",
"first_name": "JOHNNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-08",
"last_updated": "2024-01-08",
"certification_date": "2024-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NM",
"license": "1122",
"primary": true
}
],
"identifiers": [],
"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 Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.