Active NPI
Carole Poppendeck, OTR
- Occupational Therapist
- Albuquerque, NM
National Provider Identifier
1508074824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1174
- Practice address
- 8300 Constitution Ave NE
Albuquerque, NM 87110-7613 - Phone
- (505) 291-2670
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1174 | NM | Primary |
Addresses
Primary practice location
8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Mailing address
9108 Surrey Rd NE
Albuquerque, NM 87109-6802
Phone (505) 797-2079
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1174 | NM | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508074824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9108 SURREY RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871096802",
"telephone_number": "505-797-2079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8300 CONSTITUTION AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871107613",
"telephone_number": "505-291-2670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPPENDECK",
"first_name": "CAROLE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "1174",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.