Individual provider Active NPI

Ron Smock

  • Clinical Medical Laboratory
  • Albuquerque, NM
National Provider Identifier
1407411762
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
32D-0000011 Issued in NM
Practice address
4213 Montgomery Blvd NE
Albuquerque, NM 87109-1103
Phone
(505) 255-1090
Fax
(595) 345-5799
NPI assigned
May 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 32D-0000011 NM Primary

Addresses

Primary practice location

4213 Montgomery Blvd NE
Albuquerque, NM 87109-1103

Mailing address

PO Box 95708
Albuquerque, NM 87199-5708
Phone (505) 362-8039

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

State licenses

LicenseStateTypeSpecialty
32D-0000011NMMDClinical Medical Laboratory

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Drug Testing and Forensic Services Clinical Medical Laboratory CurrentSince Mar 9, 2020 Accepting new patients
Ro Smock & Associates LLC Clinical Medical Laboratory Past Accepting new patients

Locations

4213 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (281) 645-0292

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1407411762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95708",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871995708",
            "telephone_number": "505-362-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091103",
            "telephone_number": "505-255-1090",
            "fax_number": "595-345-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOCK",
        "first_name": "RON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NM",
            "license": "32D-0000011",
            "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 May 2, 2019; 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.