NPIMap

Organization Active NPI

Susan'S Legacy

  • Case Management Agency
  • Albuquerque, NM
National Provider Identifier
1477797694
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
NM600724 Issued in NM
Legal business name
SUSAN'S LEGACY
Practice address
8100 Mountain Rd. NE
Suite 200
Albuquerque, NM 87111
Phone
(505) 843-8450
Fax
(505) 843-8449
NPI assigned
May 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Dr. Kathryn Weil, PHD
Title
Executive Director
Phone
(505) 843-8450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NM600724 NM Primary

Addresses

Primary practice location

8100 Mountain Rd. NE
Suite 200
Albuquerque, NM 87111

Mailing address

11005 Spain NE
Albuquerque, NM 87111
Phone (505) 843-8450

Other identifiers 1

IdentifierTypeStateIssuer
36873594MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Susan'S Legacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1477797694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11005 SPAIN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87111",
            "telephone_number": "505-843-8450",
            "fax_number": "505-843-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 MOUNTAIN RD. NE",
            "address_2": "SUITE 200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87111",
            "telephone_number": "505-843-8450",
            "fax_number": "505-843-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN'S LEGACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-843-8450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NM",
            "license": "NM600724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36873594",
            "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 May 6, 2014; 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.