NPIMap

Organization Active NPI

James D. Mickle, Jr. MD

Doing business as Cholesterol Studies and Treatment

  • Medical Specialty Clinic/Center
  • Santa Fe, NM
National Provider Identifier
1477855104
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
MD2008-0397 Issued in NM
Legal business name
JAMES D. MICKLE, JR. MD
Doing business as
Cholesterol Studies and Treatment
Practice address
4 Calle Medico
C
Santa Fe, NM 87505-4791
Phone
(610) 952-4418
Fax
(610) 369-2710
NPI assigned
Dec 1, 2010
Last updated
Dec 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Dr. James D. Mickle Jr., MD
Title
Sole Proprietor
Phone
(610) 952-4418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X MD2008-0397 NM Primary

Addresses

Primary practice location

4 Calle Medico
C
Santa Fe, NM 87505-4791

Mailing address

4 Calle Medico
C
Santa Fe, NM 87505-4791
Phone (610) 952-4418

Other identifiers 1

IdentifierTypeStateIssuer
502171OtherPAMEDICARE ID

Other names 1

  • Cholesterol Studies and Treatment Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cholesterol Studies and Treatment2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4 Calle Medico
Ste C
Santa Fe, NM 87505
Phone (505) 699-1172

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1477855104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CALLE MEDICO",
            "address_2": "C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054791",
            "telephone_number": "610-952-4418",
            "fax_number": "610-369-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CALLE MEDICO",
            "address_2": "C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054791",
            "telephone_number": "610-952-4418",
            "fax_number": "610-369-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES D. MICKLE, JR. MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "MICKLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "610-952-4418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NM",
            "license": "MD2008-0397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "502171",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cholesterol Studies and Treatment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.