Rio West Medical, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

RIO WEST MEDICAL, LLC

Doing business as

Roadrunner Footwear and Footcare

Practice address

6200 Coors Blvd NW
Albuquerque, NM 87120-2785

Phone

(505) 896-0533

Fax

(505) 896-0522

NPI assigned

Mar 23, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Yauk, C PEDNPI 1467412676

Title

Owner

Phone

(505) 896-0533

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Roadrunner Footwear and Footcare Doing business as

Locations

Practitioners 1

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

• Sandra Yauk, C PED

  • Specialist
  • Albuquerque, NM
  • NPI 1467412676
  NPD (past) Authorized official

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1396705687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44787",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871744787",
            "telephone_number": "505-896-0533",
            "fax_number": "505-896-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 COORS BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871202785",
            "telephone_number": "505-896-0533",
            "fax_number": "505-896-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO WEST MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "YAUK",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-896-0533",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "C PED"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06587577",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06928773",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN NM",
            "identifier": "202003149",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNM",
            "identifier": "NM01TA20",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN NM",
            "identifier": "201065393",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roadrunner Footwear and Footcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Customized Equipment (DME) in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Customized Equipment (DME) in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.