Individual provider Active NPI

Angela K Packingham, FNP-C

  • Primary Care Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1477229193
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
64890 Issued in NM
Practice address
1001 Coal Ave SE
Albuquerque, NM 87106-5205
Phone
(505) 843-6168
Fax
(505) 247-9743
NPI assigned
Aug 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 64890 NM Primary

Addresses

Primary practice location

1001 Coal Ave SE
Albuquerque, NM 87106-5205

Mailing address

6320 Riverside Plaza LN NW Ste B
Albuquerque, NM 87120-1710
Phone (505) 843-6168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112002019 NM Practitioner - Nurse Practitioner 8325430804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Specialists of New Mexico LTDGroup PAC ID 5395657894, 27 clinicians

Practice addresses (Care Compare)

1001 Coal Ave SE
Albuquerque, NM 87106-5205
Phone 50584361683005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
64890NMMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Specialists of New Mexico LTD CurrentSince Jun 13, 2023 Accepting new patients

Locations

6320 Riverside Plaza Ln NW
Ste B
Albuquerque, NM 87120
Phone (505) 843-6168

1001 Coal Ave SE
Albuquerque, NM 87106
Phone (505) 841-1001

Organizations & group practices 1

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": "1629590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1477229193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 RIVERSIDE PLAZA LN NW STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201710",
            "telephone_number": "505-843-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065205",
            "telephone_number": "505-843-6168",
            "fax_number": "505-247-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKINGHAM",
        "first_name": "ANGELA",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-22",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NM",
            "license": "64890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.