NPIMap

Organization Active NPI

Behavioral Health Services of New Mexico LLC

  • Psychiatry Physician
  • Albuquerque, NM
National Provider Identifier
1477913697
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BEHAVIORAL HEALTH SERVICES OF NEW MEXICO LLC
Practice address
1525 N Renaissance Blvd NE
Albuquerque, NM 87102-6827
Phone
(505) 243-3387
NPI assigned
Mar 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Kelley Whitaker
Title
Ceo
Phone
(505) 243-3387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X NM Primary

Addresses

Primary practice location

1525 N Renaissance Blvd NE
Albuquerque, NM 87102-6827

Mailing address

1525 N Renaissance Blvd NE
Albuquerque, NM 87102-6827
Phone (505) 243-3387

Other names 1

  • Central Desert Behavioral Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151202000115 NM Part B Supplier - Clinic/Group Practice 1153570544 Receives reassigned benefits from 26 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albuquerque, NM

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1477913697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 N RENAISSANCE BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871026827",
            "telephone_number": "505-243-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 N RENAISSANCE BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871026827",
            "telephone_number": "505-243-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH SERVICES OF NEW MEXICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-243-3387"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Desert Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Desert Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.