Individual provider Active NPI

Tracy Basler, LMT#5612

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1497981229
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5612 Issued in NM
Practice address
10348 Flagstaff Dr NW
Albuquerque, NM 87114-3544
Phone
(505) 307-9964
NPI assigned
Jun 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5612 NM Primary

Addresses

Primary practice location

10348 Flagstaff Dr NW
Albuquerque, NM 87114-3544

Mailing address

10348 Flagstaff Dr. NW
Albuquerque, NM 87114
Phone (505) 307-9964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5612NMMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1497981229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10348 FLAGSTAFF DR. NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87114",
            "telephone_number": "505-307-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10348 FLAGSTAFF DR NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143544",
            "telephone_number": "505-307-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASLER",
        "first_name": "TRACY",
        "name_prefix": "Mr.",
        "credential": "LMT#5612",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "5612",
            "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 Jun 8, 2009; 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.