NPIMap

Organization Active NPI

New Mexico Childrens Kidney Center

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1245478270
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
98-339 Issued in NM
Legal business name
NEW MEXICO CHILDRENS KIDNEY CENTER
Practice address
4343 Pan American Fwy NE
#234
Albuquerque, NM 87107-6834
Phone
(505) 842-5240
Fax
(505) 242-4403
NPI assigned
Jan 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Authorized official

Name
Dr. Robert Benjamin Miller III, M.D.
Title
Pediatric Nephrology
Phone
(505) 797-8676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 98-339 NM Primary

Addresses

Primary practice location

4343 Pan American Fwy NE
#234
Albuquerque, NM 87107-6834

Mailing address

PO Box 1560
Las Cruces, NM 88004-1560
Phone (505) 842-5240

National Provider Directory

National Provider Directory

Locations

201 Cedar St SE
Ste 800
Albuquerque, NM 87106
Phone (505) 563-2500

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1245478270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1560",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880041560",
            "telephone_number": "505-842-5240",
            "fax_number": "505-242-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 PAN AMERICAN FWY NE",
            "address_2": "#234",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871076834",
            "telephone_number": "505-842-5240",
            "fax_number": "505-242-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO CHILDRENS KIDNEY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-29",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "PEDIATRIC NEPHROLOGY",
        "authorized_official_telephone_number": "505-797-8676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "98-339",
            "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 Oct 6, 2015; 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.