Organization Active NPI

Christine M. Kniffen, O.D., L.L.C.

  • Optometrist
  • Albuquerque, NM
National Provider Identifier
1356418669
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
531 Issued in NM
Legal business name
CHRISTINE M. KNIFFEN, O.D., L.L.C.
Practice address
4306 Lomas Blvd NE
Albuquerque, NM 87110-7751
Phone
(505) 265-3828
Fax
(505) 265-9684
NPI assigned
Nov 29, 2006
Last updated
Jun 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Authorized official

Name
Dr. Christine Kniffen, O.D.NPI 1619021508
Title
Owner
Phone
(505) 265-3828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 531 NM Primary

Addresses

Primary practice location

4306 Lomas Blvd NE
Albuquerque, NM 87110-7751

Mailing address

4306 Lomas Blvd NE
Albuquerque, NM 87110-7751
Phone (505) 265-3828

Other identifiers 1

IdentifierTypeStateIssuer
26155761MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090616000191 NM Part B Supplier - Clinic/Group Practice 0446300339 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

4306 Lomas Blvd NE
Albuquerque, NM 87110
Phone (505) 265-3828

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1356418669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107751",
            "telephone_number": "505-265-3828",
            "fax_number": "505-265-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107751",
            "telephone_number": "505-265-3828",
            "fax_number": "505-265-9684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE M. KNIFFEN, O.D., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "KNIFFEN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-265-3828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26155761",
            "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 Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.