NPIMap

Organization Active NPI

Gypsum Medical Associates of New Mexico, PC

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1477986065
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2011-0778 Issued in NM
Legal business name
GYPSUM MEDICAL ASSOCIATES OF NEW MEXICO, PC
Practice address
Building 9200, Area Y, Kirtland Air Force Base-East
Albuquerque, NM 87115
Phone
(224) 238-0170
NPI assigned
Aug 19, 2013
Last updated
Aug 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Authorized official

Name
Dr. George Daniel MingeaNPI 1407126972
Title
Owner, Physician
Phone
(972) 429-5809

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2011-0778 NM Primary
Pediatrics Physician 208000000X MD2011-0778 NM

Addresses

Primary practice location

Building 9200, Area Y, Kirtland Air Force Base-East
Albuquerque, NM 87115

Mailing address

4805 Prime Pkwy
McHenry, IL 60050-7002
Phone (815) 363-9500

National Provider Directory

National Provider Directory
Tax ID family
Gypsum Medical Associates of New Mexico PC2 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1477986065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 PRIME PKWY",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600507002",
            "telephone_number": "815-363-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 9200, AREA Y, KIRTLAND AIR FORCE BASE-EAST",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87115",
            "telephone_number": "224-238-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GYPSUM MEDICAL ASSOCIATES OF NEW MEXICO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "MINGEA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER, PHYSICIAN",
        "authorized_official_telephone_number": "972-429-5809",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2011-0778",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2011-0778",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Aug 19, 2013; 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.