Individual provider Active NPI

Deanna Sue Marquardt Romine

  • Diabetes Educator Registered Nurse
  • Albuquerque, NM
National Provider Identifier
1487166641
Registry record updated Oct 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
29888 Issued in NM
Practice address
4705 Montgomery Blvd NE
Albuquerque, NM 87109-1226
Phone
(505) 727-4500
Fax
(505) 727-6944
NPI assigned
Oct 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 29888 NM Primary

Addresses

Primary practice location

4705 Montgomery Blvd NE
Albuquerque, NM 87109-1226

Mailing address

PO Box 94292
Albuquerque, NM 87199-4292
Phone (505) 235-8416

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171215002613 NM Practitioner - Registered Dietitian Or Nutrition Professional 7911265111 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29888NMMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Dec 1, 2017 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Dec 1, 2017 Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

4705 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-4500

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

Organizations & group practices 2

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": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509062400000",
    "number": "1487166641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94292",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871994292",
            "telephone_number": "505-235-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091226",
            "telephone_number": "505-727-4500",
            "fax_number": "505-727-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUARDT ROMINE",
        "first_name": "DEANNA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2017-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NM",
            "license": "29888",
            "primary": true
        }
    ],
    "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 Oct 27, 2017; 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.