NPIMap

Organization Active NPI

Eye Care of New Mexico, Inc.

  • Optometrist
  • Albuquerque, NM
National Provider Identifier
1295054351
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
547 Issued in NM
Legal business name
EYE CARE OF NEW MEXICO, INC.
Practice address
500 Eubank Blvd SE
Ste. a
Albuquerque, NM 87123-3338
Phone
(505) 323-2555
Fax
(505) 323-0888
NPI assigned
May 27, 2010
Last updated
Jun 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Authorized official

Name
Dr. Wende T. Waggoner, O.D., M.P.H., M.S.
Title
President/Optometrist
Phone
(505) 323-2555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 547 NM Primary

Addresses

Primary practice location

500 Eubank Blvd SE
Ste. a
Albuquerque, NM 87123-3338

Mailing address

500 Eubank Blvd SE
Ste. a
Albuquerque, NM 87123-3338
Phone (505) 323-2555

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1295054351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EUBANK BLVD SE",
            "address_2": "STE. A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871233338",
            "telephone_number": "505-323-2555",
            "fax_number": "505-323-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EUBANK BLVD SE",
            "address_2": "STE. A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871233338",
            "telephone_number": "505-323-2555",
            "fax_number": "505-323-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE OF NEW MEXICO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-27",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "WENDE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "505-323-2555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D., M.P.H., M.S."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NM",
            "license": "547",
            "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 Jun 26, 2012; 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.