Active NPI
William Charles Abbott, MD
- Surgery Physician
- Albuquerque, NM
National Provider Identifier
1417957366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 78-99
- Practice address
- 4123 Montgomery Blvd. NE
Albuquerque, NM 87109-7719 - Phone
- (505) 884-6742
- Fax
- (505) 884-6845
- NPI assigned
- Jul 21, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 78-99 | NM | Primary |
Addresses
Primary practice location
4123 Montgomery Blvd. NE
Albuquerque, NM 87109-7719
Mailing address
4123 Montgomery Blvd. NE
Albuquerque, NM 87109-7719
Phone (505) 884-6742
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34033 | Medicaid | NM |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78-99 | NM | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1417957366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4123 MONTGOMERY BLVD. NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871097719",
"telephone_number": "505-884-6742",
"fax_number": "505-884-6845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4123 MONTGOMERY BLVD. NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871097719",
"telephone_number": "505-884-6742",
"fax_number": "505-884-6845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABBOTT",
"first_name": "WILLIAM",
"middle_name": "CHARLES",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-21",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NM",
"license": "78-99",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34033",
"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 Feb 29, 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.