Active NPI
George Eric Womble, REGISTERED NURSE
- Registered Nurse
- Kirtland Afb, NM
National Provider Identifier
1316906993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R39756
- Practice address
- 2050A 2ND St SE
Kirtland Afb, NM 87117-5522 - Phone
- (505) 846-6069
- NPI assigned
- Mar 21, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R39756 | NM | Primary |
Addresses
Primary practice location
2050A 2ND St SE
Kirtland Afb, NM 87117-5522
Mailing address
1339 Duskfire Dr NW
Albuquerque, NM 87120-5553
Phone (505) 839-4090
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 |
|---|---|---|---|
| R39756 | NM | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301529600000",
"number": "1316906993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1339 DUSKFIRE DR NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871205553",
"telephone_number": "505-839-4090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050A 2ND ST SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871175522",
"telephone_number": "505-846-6069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMBLE",
"first_name": "GEORGE",
"middle_name": "ERIC",
"credential": "REGISTERED NURSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-21",
"last_updated": "2011-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "R39756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirtland Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.