NPIMap

Organization Active NPI

Stephanie M Parks DPM LLC

  • Foot & Ankle Surgery Podiatrist
  • Albuquerque, NM
National Provider Identifier
1356817837
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
STEPHANIE M PARKS DPM LLC
Practice address
500 Walter St NE # 510a
Albuquerque, NM 87102-2534
Phone
(505) 404-9922
Fax
(505) 299-4487
NPI assigned
Oct 22, 2018
Organization subpart
Yes
Parent organization
STEPHANIE M PARKS DPM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Dr. Stephanie Parks, DPMNPI 1760747844
Title
Physician
Phone
(505) 299-4487

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

500 Walter St NE # 510a
Albuquerque, NM 87102-2534

Mailing address

500 Walter St NE
Albuquerque, NM 87102-2534
Phone (505) 404-9922

Other practice location 1

500 Walter St NE # 510A
Albuquerque, NM 87102-2534
Phone (505) 404-9922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181206003059 NM Part B Supplier - Clinic/Group Practice 8820332521 Receives reassigned benefits from 2 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory
Part of
Stephanie M Parks DPM LLC

Locations

7700 Menaul Blvd NE
Ste D
Albuquerque, NM 87110
Phone (505) 299-4487

500 Walter St NE
Ste 510A
Albuquerque, NM 87102
Phone (505) 404-9922

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1356817837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022534",
            "telephone_number": "505-404-9922",
            "fax_number": "505-299-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE # 510A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022534",
            "telephone_number": "505-404-9922",
            "fax_number": "505-299-4487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Walter St NE # 510A",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022534",
            "country_code": "US",
            "telephone_number": "505-404-9922",
            "fax_number": "505-299-4487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STEPHANIE M PARKS DPM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEPHANIE M PARKS DPM LLC",
        "enumeration_date": "2018-10-22",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "505-299-4487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "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 Apr 30, 2024; 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.