Active NPI
Ricardo Davila, M.D.
- Public Health & General Preventive Medicine Physician
- Albuquerque, NM
National Provider Identifier
1366530933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- J6101
- Practice address
- 1501 San Pedro SE
New Mexico VA Health Care System
Albuquerque, NM 87108-5154 - Phone
- (505) 265-1711
- Fax
- (505) 256-5466
- NPI assigned
- Oct 10, 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 |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | J6101 | TX | Primary |
Addresses
Primary practice location
1501 San Pedro SE
New Mexico VA Health Care System
Albuquerque, NM 87108-5154
Mailing address
6601 Tennyson St NE
Apt # 14203
Albuquerque, NM 87111-8161
Phone (520) 249-9177
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J6101 | TX | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366530933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6601 TENNYSON ST NE",
"address_2": "APT # 14203",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871118161",
"telephone_number": "520-249-9177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 SAN PEDRO SE",
"address_2": "NEW MEXICO VA HEALTH CARE SYSTEM",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871085154",
"telephone_number": "505-265-1711",
"fax_number": "505-256-5466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVILA",
"first_name": "RICARDO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "TX",
"license": "J6101",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.