Individual provider Active NPI

Dina Jene Reid, CNP

  • Women's Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1386938553
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
CNP000025 Issued in NM
Practice address
13512 Terragon Dr NE
Albuquerque, NM 87112-6333
Phone
(505) 379-8232
Fax
(505) 503-1518
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R07910 NM
Women's Health Nurse Practitioner 363LW0102X CNP000025 NM Primary

Addresses

Primary practice location

13512 Terragon Dr NE
Albuquerque, NM 87112-6333

Mailing address

13512 Terragon Dr NE
Albuquerque, NM 87112-6333
Phone (505) 379-8232

Other identifiers 1

IdentifierTypeStateIssuer
1386938553MedicaidNM

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)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP000025NMMDWomen's Health Nurse Practitioner
R07910NMMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1386938553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13512 TERRAGON DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871126333",
            "telephone_number": "505-379-8232",
            "fax_number": "505-503-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13512 TERRAGON DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871126333",
            "telephone_number": "505-379-8232",
            "fax_number": "505-503-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "DINA",
        "middle_name": "JENE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NM",
            "license": "R07910",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NM",
            "license": "CNP000025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386938553",
            "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 Jul 7, 2021; 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.