NPIMap

Organization Active NPI

Infectious Diseases and Internal Medicine

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1326044512
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
78-15 Issued in NM
Legal business name
INFECTIOUS DISEASES AND INTERNAL MEDICINE
Practice address
5901 Harper Dr NE
Albuquerque, NM 87109-3587
Phone
(505) 848-3730
Fax
(505) 848-3732
NPI assigned
Jun 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Authorized official

Name
Janiva Back
Title
Practice Manager
Phone
(505) 848-3730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 78-15 NM Primary

Addresses

Primary practice location

5901 Harper Dr NE
Albuquerque, NM 87109-3587

Mailing address

5901 Harper Dr NE
Albuquerque, NM 87109-3587
Phone (505) 848-3730

National Provider Directory

National Provider Directory
Tax ID family
Infectious Disease Int Med ASC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1326044512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 HARPER DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093587",
            "telephone_number": "505-848-3730",
            "fax_number": "505-848-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 HARPER DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093587",
            "telephone_number": "505-848-3730",
            "fax_number": "505-848-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES AND INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "BACK",
        "authorized_official_first_name": "JANIVA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "505-848-3730"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "78-15",
            "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 Dec 23, 2020; 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.