NPIMap

Organization Active NPI

Lovelace Sandia Health System

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1518077643
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LOVELACE SANDIA HEALTH SYSTEM
Practice address
5400 Gibson Blvd SE
Albuquerque, NM 87108-4729
Phone
(505) 262-7026
Fax
(505) 727-9276
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stephen C Petrovich
Title
SVP
Phone
(615) 296-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5400 Gibson Blvd SE
Albuquerque, NM 87108-4729

Mailing address

PO Box 26102
Albuquerque, NM 87125-6102
Phone (505) 262-7026

Other names 1

  • Lovelace Physician Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lovelace Westside Hospital24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

10501 Golf Course Rd NW
Ste 201
Albuquerque, NM 87114

8080 Academy Rd NE
Albuquerque, NM 87111
Phone (505) 727-3400

500 Walter St NE
Ste 501
Albuquerque, NM 87102
Phone (505) 244-0080

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

4705 Montgomery Blvd NE
Ste 102
Albuquerque, NM 87109
Phone (505) 727-7833

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518077643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26102",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256102",
            "telephone_number": "505-262-7026",
            "fax_number": "505-727-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 GIBSON BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084729",
            "telephone_number": "505-262-7026",
            "fax_number": "505-727-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVELACE SANDIA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "615-296-3000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lovelace Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 22, 2020; 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.