Individual provider Active NPI

Patrick J. Hepburn Sr., LMT

  • Specialist
  • Rio Rancho, NM
National Provider Identifier
1578632584
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
LMT4662 Issued in NM
Practice address
1808 34TH St SE
Rio Rancho, NM 87124-1782
Phone
(505) 891-9796
Fax
(505) 891-9796
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X LMT4662 NM Primary

Addresses

Primary practice location

1808 34TH St SE
Rio Rancho, NM 87124-1782

Mailing address

1808 34TH St SE
Rio Rancho, NM 87124-1782
Phone (505) 891-9796

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
LMT4662NMMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578632584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 34TH ST SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241782",
            "telephone_number": "505-891-9796",
            "fax_number": "505-891-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 34TH ST SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241782",
            "telephone_number": "505-891-9796",
            "fax_number": "505-891-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPBURN",
        "first_name": "PATRICK",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "LMT4662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, 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.

Verify at the official NPI Registry.