Individual provider Active NPI

Annette M Maxedon, CFNP

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1306967930
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP00896 Issued in NM
Practice address
1001 Coal Ave SE
Albuquerque, NM 87106-5205
Phone
(505) 843-6168
Fax
(505) 247-9743
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP00896 NM Primary

Addresses

Primary practice location

1001 Coal Ave SE
Albuquerque, NM 87106-5205

Mailing address

6320 Riverside Plaza LN NW Ste B
Albuquerque, NM 87120-1710
Phone (505) 843-6168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090203000671 NM Practitioner - Nurse Practitioner 0345304457 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Specialists of New Mexico LTDGroup PAC ID 5395657894, 27 clinicians

Practice addresses (Care Compare)

1001 Coal Ave SE
Albuquerque, NM 87106-5205
Phone 50584361683005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP00896NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare New Mexico LLC CurrentSince Jan 12, 2009 Accepting new patients
Womens Specialists of New Mexico LTD CurrentSince Feb 3, 2025 Accepting new patients
Optumcare Endoscopy Center New Mexico, LLC Past Accepting new patients

Locations

1001 Coal Ave SE
Albuquerque, NM 87106
Phone (505) 841-1001

5150 Journal Center Blvd NE
Fl 3
Albuquerque, NM 87109
Phone (505) 262-3212

6320 Riverside Plaza Ln NW
Ste B
Albuquerque, NM 87120
Phone (505) 843-6168

1721 Rio Rancho Blvd SE
Rio Rancho, NM 87124
Phone (505) 208-4413

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1306967930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 RIVERSIDE PLAZA LN NW STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201710",
            "telephone_number": "505-843-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065205",
            "telephone_number": "505-843-6168",
            "fax_number": "505-247-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXEDON",
        "first_name": "ANNETTE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP00896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.