NPIMap

Organization Active NPI

Southwest Center for Integrative Medicine

  • General Practice Physician
  • Albuquerque, NM
National Provider Identifier
1497026405
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
BB7316436 Issued in NM
Legal business name
SOUTHWEST CENTER FOR INTEGRATIVE MEDICINE
Practice address
1012 Eubank Blvd NE
Albuquerque, NM 87112-5310
Phone
(505) 298-4325
Fax
(505) 294-5407
NPI assigned
Jan 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Authorized official

Name
Dominic Stape, D.O.M.
Title
C.E.O./ Owner
Phone
(505) 298-4325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X BB7316436 NM Primary

Addresses

Primary practice location

1012 Eubank Blvd NE
Albuquerque, NM 87112-5310

Mailing address

1012 Eubank Blvd NE
Albuquerque, NM 87112-5310
Phone (505) 298-4325

National Provider Directory

National Provider Directory

Locations

1012 Eubank Blvd NE
Albuquerque, NM 87112
Phone (505) 298-4325

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1497026405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 EUBANK BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125310",
            "telephone_number": "505-298-4325",
            "fax_number": "505-294-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 EUBANK BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125310",
            "telephone_number": "505-298-4325",
            "fax_number": "505-294-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST CENTER FOR INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "STAPE",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_title_or_position": "C.E.O./ OWNER",
        "authorized_official_telephone_number": "505-298-4325",
        "authorized_official_credential": "D.O.M."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NM",
            "license": "BB7316436",
            "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 May 10, 2012; 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.