Individual provider Active NPI

Kim Weddle, DC, APCP

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1467544379
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26823 Issued in CA
Practice address
4700 Jefferson St NE
Ste 100
Albuquerque, NM 87109-2136
Phone
(505) 925-7464
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1889 NM
Chiropractor 111N00000X DC26823 CA Primary

Addresses

Primary practice location

4700 Jefferson St NE
Ste 100
Albuquerque, NM 87109-2136

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310
Phone (505) 272-1476

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UNMMG@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151210002368 NM Practitioner - Chiropractic 8123029543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unm Medical Group IncGroup PAC ID 4981795267, 1,052 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2111

Hospital & facility affiliations

  • Unm Hospital Hospital, Albuquerque, NM, CCN 320001

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1889NMMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group, Inc. CurrentSince Nov 11, 2015 Accepting new patients
Unm Medical Group Inc CurrentSince Nov 11, 2015 Accepting new patients
Unm Medical Group Inc Past Accepting new patients

Locations

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

801 Encino Pl NE
Ste F
Albuquerque, NM 87102
Phone (505) 272-1312

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1467544379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310",
            "telephone_number": "505-272-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 JEFFERSON ST NE",
            "address_2": "STE 100",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092136",
            "telephone_number": "505-925-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDDLE",
        "first_name": "KIM",
        "name_prefix": "Ms.",
        "credential": "DC, APCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1889",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.