Active NPI
Barbara Jean Bath, MD
- Family Medicine Physician
- Albuquerque, NM
National Provider Identifier
1285616623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 96-11
- Practice address
- 4420 Irving Blvd NW
Albuquerque, NM 87114-5915 - Phone
- (505) 727-6300
- Fax
- (505) 727-9588
- NPI assigned
- Nov 18, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 96-11 | NM | Primary |
Addresses
Primary practice location
4420 Irving Blvd NW
Albuquerque, NM 87114-5915
Mailing address
4420 Irving Blvd NW
Albuquerque, NM 87114-5915
Phone (505) 727-6300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 425662YR41 | Other | NM | MEDICARE PTAN |
| 000H5175 | 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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 96-11 | NM | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442880000000",
"number": "1285616623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4420 IRVING BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871145915",
"telephone_number": "505-727-6300",
"fax_number": "505-727-9588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 IRVING BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871145915",
"telephone_number": "505-727-6300",
"fax_number": "505-727-9588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATH",
"first_name": "BARBARA",
"middle_name": "JEAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-18",
"last_updated": "2015-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "96-11",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "425662YR41",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000H5175",
"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 22, 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.